Arjan S Sehmbi1, Saied Froghi2, Matheus Oliveira de Andrade3, Nader Saffari3, Barry Fuller4, Alberto Quaglia5, Brian Davidson6. 1. Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Garrod Building, Whitechapel, London, UK. 2. Department of HPB & Liver Transplantation, Royal Free Hospital Hampstead, London, UK; Division of Surgery & Interventional Sciences, University College London, Royal Free Campus, Hampstead, London, UK. Electronic address: sidfrg@doctors.org.uk. 3. Faculty of Engineering Sciences, University College London, Gower Street, London, UK. 4. Division of Surgery & Interventional Sciences, University College London, Royal Free Campus, Hampstead, London, UK. 5. Department of Pathology, Royal Free Hospital, Hampstead, London, UK. 6. Department of HPB & Liver Transplantation, Royal Free Hospital Hampstead, London, UK; Division of Surgery & Interventional Sciences, University College London, Royal Free Campus, Hampstead, London, UK.
Abstract
BACKGROUND: High Intensity Focused Ultrasound (HIFU) is an emerging non-invasive, targeted treatment of malignancy. The aim of this review was to assess the efficacy, safety and optimal technical parameters of HIFU to treat malignant lesions of the hepatobiliary system. METHODS: A systematic search of the English literature was performed until March 2020, interrogating Pubmed, Embase and Cochrane Library databases. The following key-words were input in various combinations: 'HIFU', 'High intensity focussed ultrasound', 'Hepatobiliary', 'Liver', 'Cancer' and 'Carcinoma'. Extracted content included: Application type, Exposure parameters, Patient demographics, and Treatment outcomes. RESULTS: Twenty-four articles reported on the clinical use of HIFU in 940 individuals to treat malignant liver lesions. Twenty-one studies detailed the use of HIFU to treat hepatocellular carcinoma only. Mean tumour size was 5.1 cm. Across all studies, HIFU resulted in complete tumour ablation in 55% of patients. Data on technical parameters and the procedural structure was very heterogeneous. Ten studies (n = 537 (57%) patients) described the use of HIFU alongside other modalities including TACE, RFA and PEI; 66% of which resulted in complete tumour ablation. Most common complications were skin burns (15%), local pain (5%) and fever (2%). CONCLUSION: HIFU has demonstrated benefit as a treatment modality for malignant lesions of the hepatobiliary system. Combining HIFU with other ablative therapies, particularly TACE, increases the efficacy without increasing complications. Future human clinical studies are required to determine the optimal treatment parameters, better define outcomes and explore the risks and benefits of combination therapies. Crown
BACKGROUND: High Intensity Focused Ultrasound (HIFU) is an emerging non-invasive, targeted treatment of malignancy. The aim of this review was to assess the efficacy, safety and optimal technical parameters of HIFU to treat malignant lesions of the hepatobiliary system. METHODS: A systematic search of the English literature was performed until March 2020, interrogating Pubmed, Embase and Cochrane Library databases. The following key-words were input in various combinations: 'HIFU', 'High intensity focussed ultrasound', 'Hepatobiliary', 'Liver', 'Cancer' and 'Carcinoma'. Extracted content included: Application type, Exposure parameters, Patient demographics, and Treatment outcomes. RESULTS: Twenty-four articles reported on the clinical use of HIFU in 940 individuals to treat malignant liver lesions. Twenty-one studies detailed the use of HIFU to treat hepatocellular carcinoma only. Mean tumour size was 5.1 cm. Across all studies, HIFU resulted in complete tumour ablation in 55% of patients. Data on technical parameters and the procedural structure was very heterogeneous. Ten studies (n = 537 (57%) patients) described the use of HIFU alongside other modalities including TACE, RFA and PEI; 66% of which resulted in complete tumour ablation. Most common complications were skin burns (15%), local pain (5%) and fever (2%). CONCLUSION: HIFU has demonstrated benefit as a treatment modality for malignant lesions of the hepatobiliary system. Combining HIFU with other ablative therapies, particularly TACE, increases the efficacy without increasing complications. Future human clinical studies are required to determine the optimal treatment parameters, better define outcomes and explore the risks and benefits of combination therapies. Crown
Authors: Yun-Bing Wang; Rong Ma; Zhi-Biao Wang; Qiu-Ling Shi; Lian Zhang; Wen-Zhi Chen; Jian-Ping Gong; Jin Bai Journal: Front Oncol Date: 2022-03-28 Impact factor: 6.244