Published online Dec 15, 2015. doi: 10.4251/wjgo.v7.i12.466
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
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.
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.