Endoscopic ultrasound role in pancreatic adenocarcinoma treatment: A review focusing on technical success, safety and efficacy

Table 1 Human studies reporting endoscopic ultrasound-guided intra-tumoral injection therapies

Ref.	Study design	Cancer stage	EUS-guided intervention	Patients No.	Technical success (%)	Median overall survival (mo)	Pain palliation	Serious adverse events, n
Levy et al[9], 2017	Prospective	II (n = 3); III (n = 20); IV (n = 13)	Chemotherapy	36	100	10.4	Not reported	0
Chang et al[10], 2000	Prospective	II (n = 4); III (n = 3); IV (n = 1)	Immunotherapy	8	100	13.2	Not reported	0
Irisawa et al[11], 2007	Prospective	IV (n = 7)	Immunotherapy	7	100	9.9	Not reported	0
Endo et al[12], 2012	Prospective	II (n = 1); III (n = 5); IV (n = 3)	Immunotherapy	9	100	18	Not reported	31
Buscail et al[23], 2015	Prospective	III (n = 13); IV (n = 9)	Gene therapy	22	100	12.6	Not reported	0
Hecht et al[14], 2003	Prospective	III (n = 9); IV (n = 21)	Gene therapy	21	100	7.5	Not reported	42
Hecht et al[16], 2012	Prospective	III (n = 27)	Gene therapy	27/50	100	9.9	Not reported	403
Herman et al[17], 2013	Prospective	III (n = 95)	Gene therapy	95/187	100	11.5	Not reported	484
Hanna et al[18], 2012	Prospective	Unresectable	Gene therapy	6	100	6	Not reported	15
Hirooka et al[20], 2018	Prospective	III (n = 9)	Gene therapy	9	100	15.5	Not reported	26
Nishimura et al[22], 2018	Prospective	III (n = 5); IV (n = 1)	Gene therapy	6	100	5.8	Not reported	0
Golan et al[25], 2015	Prospective	III (n = 15)	Intra-tumoral implantation	15	100	15.1	Not reported	47

¹Pancreatic fistula (2 patients) and superior mesenteric artery pseudoaneurysm (1 patient).

²Sepsis (2 patients), duodenal perforations (2 patients).

³The authors did not state whether these adverse events were in the endoscopic ultrasound (EUS) group or in the percutaneous group: Gastrointestinal bleeding (6 patients), deep vein thrombosis (6 patients), pulmonary embolism (2 patients), pancreatitis (2 patients), cholecystitis (1 patient), biliary obstruction (8 patients), cholangitis (6 patients), hypotension (2 patients), bradycardia (1 patient), supraventricular tachycardia (1 patient), splenic artery thrombosis (1 patient), intestinal ischemia (1 patient), staphylococcus infection (1 patient), cerebrovascular accident (1 patient), cardio-pulmonary arrest (1 patient).

⁴The authors did not state what are the serious adverse events and whether these adverse events were in the EUS group or in the percutaneous group.

⁵Hypoglycemia (1 patient).

⁶Perforation of duodenum (1 patient) and hepatic dysfunction 1 patient), but these events were considered not to be related.

⁷Colonic obstruction (1 patient), pancreatitis (1 patient), cholangitis (1 patient), renal failure (1 patient).