Is alcohol required for effective pancreatic cyst ablation? The prospective randomized CHARM trial pilot study
| Autor: | Nelson S. Yee, Matthew T. Moyer, Charles Dye, Bradley Mathers, John M. Levenick, Niraj J. Gusani, Brooke Ancrile, Setareh Sharzehi, Brandy Dougherty-Hamod, Thomas J. McGarrity, Joyce Wong, Abraham Mathew |
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| Rok vydání: | 2016 |
| Předmět: |
Endoscopic ultrasound
medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Ablation medicine.disease Article Gemcitabine Surgery 03 medical and health sciences 0302 clinical medicine Fine-needle aspiration 030220 oncology & carcinogenesis medicine Acute pancreatitis lcsh:Diseases of the digestive system. Gastroenterology 030211 gastroenterology & hepatology Pharmacology (medical) Cyst lcsh:RC799-869 Pancreatic cysts Adverse effect business medicine.drug |
| Zdroj: | Endoscopy International Open Endoscopy International Open, Vol 04, Iss 05, Pp E603-E607 (2016) |
| ISSN: | 2196-9736 2364-3722 |
| DOI: | 10.1055/s-0042-105431 |
| Popis: | Background and study aims: In this study, we aim to determine the safety and feasibility of an alcohol-free approach to pancreatic cyst ablation using a chemotherapeutic ablation cocktail. Patients and methods: In this prospective, randomized, double-blinded pilot study, 10 patients with known mucinous type pancreatic cysts underwent endoscopic ultrasound (EUS)-guided fine needle aspiration and then lavage with either 80 % ethanol or normal saline. Both groups were then treated with a cocktail of paclitaxel and gemcitabine. Primary outcomes were reduction in cyst volume and rates of complications. Results: At 6 months, patients randomized to the alcohol arm had an 89 % average volume reduction, with a 91 % reduction noted in the alcohol-free arm. Complete ablation was achieved in 67 % of patients in the alcohol-free arm at both 6 and 12 months, whereas the alcohol group recorded complete ablation rates of 50 % and 75 % at 6 and 12 months, respectively. One patient in the alcohol arm developed acute pancreatitis (20 %) with no adverse events in the alcohol-free arm. Conclusions: This study revealed similar ablation rates between the alcohol ablation group and the alcohol-free arm and demonstrates the safety and feasibility of an alcohol-free ablation protocol. This pilot study suggests that alcohol may not be required for effective cyst ablation. |
| Databáze: | OpenAIRE |
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