High-Intensity Focused Ultrasound (HIFU) in Pancreatic Cancer-Related Pain: Current Evidence and Future Directions.

Pancreatic cancer is a highly malignant gastrointestinal tumor, frequently accompanied by severe cancer-related pain that significantly diminishes patients' quality of life. High-intensity focused ultrasound (HIFU), a non-invasive therapeutic modality, alleviates cancer pain through multiple mechanisms, including the induction of coagulative necrosis through rapid temperature elevation in targeted tissues, disruption of nerve fibers within the tumor microenvironment, and modulation of inflammatory factor release. In combination therapy, HIFU can be integrated with radiotherapy, chemotherapy and immunotherapy to enhance therapeutic efficacy and potentially delay disease progression. However, HIFU treatment is associated with certain adverse effects, including skin burns, pancreatitis, and damage to adjacent organs. Most of these adverse reactions are mild, self-limiting, and do not require specific medical intervention, with no reported fatal cases. Despite its favorable safety profile, meticulous patient selection and optimization of treatment parameters remain crucial. Compared to conventional treatment modalities, HIFU offers several advantages, such as noninvasiveness, repeatability, short recovery time, and precise targeting. However, challenges persist, including limitations in imaging accuracy, treatment zone delineation, and the development of personalized treatment protocols. Future advances that integrate sophisticated imaging guidance and precise energy modulation are expected to further enhance the efficacy of HIFU in alleviating pancreatic cancer related pain, thereby providing a promising therapeutic strategy in clinical practice.