Review Article

Endoscopic Ultrasound-Guided Therapies in Pancreatic Neoplasms

Table 1

EUS-guided therapy for pancreatic adenocarcinoma (human studies).

TechniqueReferencesOutcomeAdverse events

Immunologic therapy
CytoimplantChang et al. 2000 [5]82 partial response 
1 minor response 
3 stable disease 
2 progressive disease
None
Immature DCsIrisawa et al. 2007 [7]73 mixed response*
1 stable disease 
3 progressive disease
None
Gemcitabine and DCsHirooka et al. 2009 [8]51 partial response 
2 stable disease 
2 progressive disease
Leukopenia () 
Anemia () 
Nausea and constipation ()

Biologic therapy
Oncolytic virus (ONYX-015)Hecht et al. 2003 [10]212 partial response 
8 stable disease 
12 progressive disease
Sepsis () 
Duodenal perforation from EUS-FNI () 
Leukopenia () 
Anemia ()
TNFerade (EUS , percutaneous )Hecht et al. 2012 [12]501 complete response 
3 partial response 
4 minor response 
12 stable disease 
19 progressive disease
GI bleeding (), DVT (), PE (), abdominal pain (), pancreatitis (), cholangitis () 
biliary obstruction (), coagulopathy (), nausea/vomiting (), hypotension (), intestinal ischemia (), cardiopulmonary events (), electrolyte abnormalities (), death unrelated to treatment ()

Physiochemical therapy
EUS-guided interstitial brachytherapy Sun et al. 2006 [17]154 partial response 
3 minor response 
5 stable disease 
3 progressive disease
Leukopenia (), anemia (), thrombocytopenia (), abnormal liver tests (), nausea/vomiting (), fever (), infection (), constipation (), diarrhea ()
Jin et al. 2008 [18]223 partial response 
10 stable disease 
9 disease progression
Seed translocated to liver 24 h after procedure (), fevers (), amylase elevation ()

Regression of main pancreatic tumor but stable/progression of other lesions.