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Contrast-enhanced harmonic endoscopic ultrasonography for evaluating the response to chemotherapy in pancreatic
Hidekazu Tanaka1, Ken Kamata1, Mamoru Takenaka1
1Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-sayama, Japan.
Background And Aims:
Contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) is used for the diagnosis of pancreatic cancer (PC). Here, we examined the usefulness of CH-EUS for evaluating therapeutic responses in PC.
Methods:
The study included 23 patients with PC who received chemotherapy. Patients underwent contrast-enhanced computed tomography (CE-CT) and CH-EUS before chemotherapy and at the time of evaluation of the therapeutic response. Patients with a ≧50% reduction in serum carbohydrate antigen 19-9 levels after chemotherapy were defined as "super responders". The incidence of an avascular area in the tumor on CH-EUS after chemotherapy was compared between "super responders" and non-super responders.
Results:
Nine patients were included in the "super responders" group.Tumor reduction rates did not differ significantly between CE-CT and CH-EUS in the "super responders". The appearance of an avascular area was detected in 7 of 9 super responders (77.8%) and in 4 of 14 non-super responders (28.6%), and the difference was significant (P = 0.036). The mean survival time of patients with an avascular area after chemotherapy was longer than that of without an avascular area.
Conclusions:
Detection of avascular areas by CH-EUS after chemotherapy may predict long-term survival of patients with PC.
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