Treatment of esophageal tumors using high intensity intraluminal ultrasound: first clinical resultsReport as inadecuate




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Journal of Translational Medicine

, 6:28

First Online: 05 June 2008Received: 08 February 2008Accepted: 05 June 2008DOI: 10.1186-1479-5876-6-28

Cite this article as: Melodelima, D., Prat, F., Fritsch, J. et al. J Transl Med 2008 6: 28. doi:10.1186-1479-5876-6-28

Abstract

BackgroundEsophageal tumors generally bear a poor prognosis. Radical surgery is generally the only curative method available but is not feasible in the majority of patients; palliative therapy with stent placement is generally performed. It has been demonstrated that High Intensity Ultrasound can induce rapid, complete and well-defined coagulation necrosis. Thus, for the treatment of esophageal tumors, we have designed an ultrasound applicator that uses an intraluminal approach to fill up this therapeutic gap.

MethodsThermal ablation is performed with water-cooled ultrasound transducers operating at a frequency of 10 MHz. Single lesions extend from the transducer surface up to 10 mm in depth when applying an intensity of 14 W-cm for 10s. A lumen inside the therapy applicator provides path for an endoscopic ultrasound imaging probe operating at a frequency of 12 MHz. The mechanical rotation of the applicator around its axis enables treatment of sectorial or cylindrical volumes. This method is thus particularly suitable for esophageal tumors that may develop only on a portion of the esophageal circumference. Previous experiments were conducted from bench to in vivo studies on pig esophagi.

ResultsHere we report clinical results obtained on four patients included in a pilot study. The treatment of esophageal tumors was performed under fluoroscopic guidance and ultrasound imaging. Objective tumor response was obtained in all cases and a complete necrosis of a tumor was obtained in one case. All patients recovered uneventfully and dysphagia improved significantly within 15 days, allowing for resuming a solid diet in three cases.

ConclusionThis clinical work demonstrated the efficacy of intraluminal high intensity ultrasound therapy for local tumor destruction in the esophagus.

List of abbreviationsUSUltrasound

EUSEndoscopic sonography

ASAAmerica, Society of Anesthesiology classification

SCCsquamous cell carcinoma

ACadenocarcinoma

ODouter diameter

CT-scancomputerised tomography scan

RT-CTRadiochemotherapy.

Electronic supplementary materialThe online version of this article doi:10.1186-1479-5876-6-28 contains supplementary material, which is available to authorized users.

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Author: David Melodelima - Frederic Prat - Jacques Fritsch - Yves Theillere - Dominique Cathignol

Source: https://link.springer.com/







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