Matsumoto Kazuyuki, Kato Hironari, Tsutsumi Koichiro, Otsuka Motoyuki
Department of Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan.
Dig Endosc. 2025 Jan;37(1):18-28. doi: 10.1111/den.14815. Epub 2024 May 16.
Endoscopic ultrasound (EUS) was developed in the 1990s and has significantly transformed pancreatic tumor diagnosis. Subsequently, EUS has rapidly shifted from being a purely diagnostic procedure to being used in a wide range of interventional procedures. Recently, new therapeutic techniques, such as EUS-guided fine needle injection (EUS-FNI) or radiofrequency ablation (RFA), have been developed to deliver various antitumor agents. Despite technological advancements, pancreatic cancer (PC) has a poor prognosis and improvements in treatment outcomes are urgently required. One of the reasons for the limited response to antitumor agents in PC is the abundant desmoplasia and hypovascular nature of the tumor, complicating drug delivery into the tumor. Thus, changing the tumor microenvironment may be important to enhance the effectiveness of chemotherapy, and direct injection of antitumor agents into the tumor under EUS guidance can help overcome treatment challenges in PC. Treatment approaches using the EUS-FNI or RFA technique are expected to further improve the prognosis of PC. Therefore, this study reviewed the existing literature on EUS-guided antitumor therapy, specifically highlighting its application in PC to address the current challenges and to identify potential advancements in the field.
内镜超声（EUS）于20世纪90年代问世，极大地改变了胰腺肿瘤的诊断方式。随后，EUS迅速从单纯的诊断手段转变为广泛应用于各种介入手术。近年来，诸如EUS引导下细针注射（EUS-FNI）或射频消融（RFA）等新的治疗技术已被开发出来，用于递送各种抗肿瘤药物。尽管技术不断进步，但胰腺癌（PC）的预后仍然很差，迫切需要改善治疗效果。PC对抗肿瘤药物反应有限的原因之一是肿瘤大量的纤维组织增生和血管生成不足，这使得药物输送到肿瘤中变得复杂。因此，改变肿瘤微环境对于提高化疗效果可能很重要，而在EUS引导下将抗肿瘤药物直接注射到肿瘤中有助于克服PC的治疗挑战。使用EUS-FNI或RFA技术的治疗方法有望进一步改善PC的预后。因此，本研究回顾了关于EUS引导下抗肿瘤治疗的现有文献，特别强调了其在PC中的应用，以应对当前的挑战并确定该领域的潜在进展。
