Table 2.
Summary of Results for Selected Studies Utilizing EUS-Guided Intratumoral Drug Delivery for PCN Ablation.
| Author | Study Year | Ablative Strategy | Number of Treated Patients | Number of Treated Lesions | Efficacy on Follow-Up Imaging **, n (%) | Adverse Events, (n) | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| MCN | IPMN | Other * | Incomplete Response | Partial Response | Complete Response | |||||
| Oh et al. [7] | 2008 | Ethanol (88–99%) + Paclitaxel | 14 | 2 | 0 | 12 | 1 (7) | 2 (14) | 11 (79) | Mild abdominal pain (1); Acute pancreatitis (1) |
| Oh et al. [61] | 2009 | Ethanol (99%) + Paclitaxel | 10 | 3 | 0 | 7 | 2 (20) | 2 (20) | 6 (60) | Acute pancreatitis (1) |
| Oh et al. [6] | 2011 | Ethanol (99%) + Paclitaxel | 52 | 9 | 0 | 43 | 12 (25) | 6 (13) | 29 (62) | Fever without infection (1); Mild abdominal pain (1); Acute pancreatitis (1); Splenic vein obliteration (1); Peri-cystic spillage (1) |
| Choi et al. [62] | 2017 | Ethanol (99%) + Paclitaxel | 164 | 71 | 11 | 82 | 13 (8) | 31 (20) | 114 (72) | Fever without infection (1); Peri-cystic spillage (1); Intra-cystic bleeding (1); Acute pancreatitis (6); Pseudocyst formation (2); Abscess formation (2); Portal vein thrombosis (1); Splenic vein obliteration (1); MPD stricture (1) |
| Kim et al. [63] | 2017 | Ethanol (100%) or Ethanol (100%) + Paclitaxel | 8 (Ethanol) 28 (Ethanol + Paclitaxel) | 16 | 14 | 6 | 8 (24) | 7 (20) | 19 (56) | Mild abdominal pain (4); Acute pancreatitis (4); Intra-cystic bleeding (1) |
| Moyer et al. [64] | 2017 | Ethanol (80%) + Paclitaxel + Gemcitabine | 18 | 9 | 27 | 3 | 3 (17) | 4 (22) | 11 (61) | Mild abdominal pain (4); Acute pancreatitis (1) |
| Saline + Paclitaxel + Gemcitabine | 21 | 4 (19) | 3 (14) | 14 (67) | None | |||||
* The designation of “Other” includes patients treated in the above studies for cystic lesions that are non-neoplastic (i.e., pseudocysts), neoplastic without malignant potential (i.e., SCNs), or indeterminate based on pre-procedural analysis. Although the scope of this review focuses on the use of EUS-guided ablative procedures in the treatment of neoplastic cysts capable of malignant transformation (i.e., MCNs and IPMNs), this column is included in the table for the purpose of completeness. ** Complete response is defined as the radiographic absence of residual lesion on post-procedural imaging. Incomplete response is defined as either persistent or enlarged residual lesion on post-procedural imaging. If the study authors noted reduction in lesion size without resolution on post-procedural imaging, this is considered a partial response; if this was not recorded by the study authors, these lesions are categorized as incomplete response.