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World J Gastrointest Oncol. Dec 15, 2015; 7(12): 466-472
Published online Dec 15, 2015. doi: 10.4251/wjgo.v7.i12.466
Endoscopic ultrasound-fine needle injection for oncological therapy
Jeremy Kaplan, Amaara Khalid, Natalie Cosgrove, Ayesha Soomro, Syed Mohsin Mazhar, Ali A Siddiqui
Jeremy Kaplan, Amaara Khalid, Natalie Cosgrove, Ayesha Soomro, Syed Mohsin Mazhar, Ali A Siddiqui, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107, United States
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest statement: The authors attest that they have no commercial associations (e.g., equity ownership or interest, consultancy, patent and licensing agreement, or institutional and corporate associations) that might be a conflict of interest in relation to the submitted manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ali A Siddiqui, MD, Professor of Medicine, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Thomas Jefferson University Hospital, 132 S. 10th Street, Suite 585, Philadelphia, PA 19107, United States. ali.siddiqui@jefferson.edu
Telephone: +1-215-9550218 Fax: +1-215-9556678
Received: June 8, 2015
Peer-review started: June 10, 2015
First decision: July 10, 2015
Revised: September 11, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: December 15, 2015
Abstract

The minimal invasiveness and precision of endoscopic ultrasound (EUS) has lead to both its widespread use as a diagnostic and staging modality for gastrointestinal and pancreaticobiliary malignancies, and to its expanding role as a therapeutic modality. EUS-guided celiac plexus neurolysis is now a well-accepted modality for palliation of pain in patients with pancreatic cancer. EUS-guided ablation, brachytherapy, fiducial marker placement, and antitumor agent injection have been described as methods of performing minimally invasive oncological therapy. EUS-fine needle injection may be performed as adjunctive, alternative, or palliative treatment. This review summarizes the studies to date that have described these methods. A literature search using the PubMed/MEDLINE databases was performed. While most published studies to date are limited with disappointing outcomes, the concept of a role of EUS in oncological therapy seems promising.

Keywords: Endoscopic ultrasound-fine needle injection, Endoscopic ultrasound-guided ablation, Photodynamic therapy, Radiofrequency ablation, Cryothermal ablation, Endoscopic ultrasound-guided brachytherapy, Fiducial markers, Endoscopic ultrasound-guided antitumor agent injection

Core tip: In the present review, the novel use of endoscopic ultrasound-fine needle injection (EUS-FNI) in oncological therapy is described. EUS-FNI is a promising method to optimize treatment to a targeted area while minimizing procedure invasiveness and systemic toxicity. EUS-guided ablation, brachytherapy, fiducial marker placement, and antitumor agent injection have been described to date. While these procedures appear to be safe and reasonably well tolerated, their effectiveness and exact role in oncological treatment have yet to be established.