Publication date: Available online 13 December 2018
Source: Ultrasound in Medicine & Biology
Author(s): Takuji Iwashita, Shinya Uemura, Masahito Shimizu, Fuminori Hyodo, Hiroyuki Tomita, Ryota Iwasaki, Masaki Takasu, Takashi Mori, Hidekazu Tanaka, Masayuki Matsuo
Abstract
Hydrogen peroxide (H2O2) has been reported to be an effective radiation sensitizer for various cancers. A combination therapy comprising fine-needle injection (FNI) of H2O2 under endoscopic ultrasound (EUS) guidance and chemoradiation might improve treatment outcomes of pancreatic cancer; however, there have been no reports thus far. The aims of this study were to evaluate the feasibility and safety of EUS-FNI of H2O2 into the pancreas using a porcine survival model. EUS-FNI was performed in the pancreas of six pigs, which were randomly divided into three groups based on the solution injected: group 1, 2 mL of sodium hyaluronate (control); group 2, 0.5 mL of H2O2; group 3, 2 mL of H2O2. To evaluate any adverse events, blood tests and computed tomography (CT) were performed before and after FNI, as well as days 3 and 7 subsequently. The pigs were necropsied on day 7. Histologic evaluation was performed according to the criteria for experimental acute pancreatitis. EUS-FNI was successful in all pigs. CT immediately after FNI revealed gas formation in the FNI area in groups 2 and 3. No adverse events were revealed by blood tests and CT. Histologic evaluations revealed pancreatitis scores of 5 and 5 in group 1, 7 and 7 in group 2 and 14 and 15 in group 3. EUS-FNI of H2O2 into the pancreas is feasible; however, it could cause pancreatitis. FNI of H2O2 into only the pancreatic tumor might be ideal in minimizing possible adverse events.
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