Skip to main content
Erschienen in: European Radiology 8/2021

23.01.2021 | Hepatobiliary-Pancreas

Improving quality of life in pancreatic cancer patients following high-intensity focused ultrasound (HIFU) in two European centers

verfasst von: Milka Marinova, Hyuliya Feradova, Maria A. Gonzalez-Carmona, Rupert Conrad, Tolga Tonguc, Marcus Thudium, Marc U. Becher, Zhou Kun, Grigor Gorchev, Slavcho Tomov, Christian P. Strassburg, Ulrike Attenberger, Hans H. Schild, Dobromir Dimitrov, Holger M. Strunk

Erschienen in: European Radiology | Ausgabe 8/2021

Einloggen, um Zugang zu erhalten

Abstract

Objectives

Pancreatic cancer patients often have a high symptom burden, significantly impairing patients’ quality of life (QOL). Nevertheless, there are hardly any reports on the impact of high-intensity focused ultrasound (HIFU) on the QOL of treated patients. For the first time, this study evaluated the effect of HIFU on QOL and compared these results in two European centers.

Methods

Eighty patients with advanced pancreatic cancer underwent HIFU (50 in Germany, 30 in Bulgaria). Clinical assessment included evaluation of QOL and symptoms using the EORTC QLQ-C30 questionnaire at baseline and 1, 3, and 6 months after HIFU. Pain intensity was additionally evaluated with the numerical rating score (NRS).

Results

Compared to baseline, global health significantly improved 3 and 6 months after HIFU treatment (p = 0.02). Functional subscales including physical, emotional, and social functioning were considerably improved at 6 months (p = 0.02, p = 0.01, and p = 0.01, respectively) as were leading symptom pain (p = 0.04 at 6 months), fatigue (p = 0.03 at 3 and p = 0.01 at 6 months), and appetite loss (p = 0.01 at 6 months). Moreover, pain intensity measured by NRS revealed effective and strong pain relief at all time points (p < 0.001). Reported effects were independent of tumor stage, metastatic status, and country of treatment.

Conclusions

This study showed that HIFU represents an effective treatment option of advanced pancreatic cancer improving QOL by increasing global health and mitigation of physical complaints with a low rate of side effects, independent of the examiner. Therefore, HIFU is a worthwhile additional treatment besides systemic palliative chemotherapy or best supportive care in management of this aggressive disease.

Key Points

• In a prospective two-center study, it was shown that HIFU represents an effective treatment option of advanced pancreatic cancer improving QOL.
• HIFU in pancreatic cancer patients is associated with a low rate of side effects, independent of the performer.
• HIFU is a worthwhile additional treatment besides systemic palliative chemotherapy or best supportive care in management of this aggressive disease.
Literatur
1.
Zurück zum Zitat Carrato A, Falcone A, Ducreux M et al (2015) A systematic review of the burden of pancreatic cancer in Europe: real-world impact on survival, quality of life and costs. J Gastrointest Cancer 46:201–211PubMedPubMedCentralCrossRef Carrato A, Falcone A, Ducreux M et al (2015) A systematic review of the burden of pancreatic cancer in Europe: real-world impact on survival, quality of life and costs. J Gastrointest Cancer 46:201–211PubMedPubMedCentralCrossRef
2.
3.
Zurück zum Zitat Conroy T, Desseigne F, Ychou M et al (2011) FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 364:1817–1825PubMedCrossRef Conroy T, Desseigne F, Ychou M et al (2011) FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 364:1817–1825PubMedCrossRef
4.
Zurück zum Zitat Von Hoff DD, Ervin T, Arena FP et al (2013) Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med 369:1691–1703CrossRef Von Hoff DD, Ervin T, Arena FP et al (2013) Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med 369:1691–1703CrossRef
5.
Zurück zum Zitat Wang-Gillam A, Li CP, Bodoky G et al (2016) Nanoliposomal irinotecan with fluorouracil and folinic acid in metastatic pancreatic cancer after previous gemcitabine-based therapy (NAPOLI-1): a global, randomised, open-label, phase 3 trial. Lancet 387:545–557PubMedCrossRef Wang-Gillam A, Li CP, Bodoky G et al (2016) Nanoliposomal irinotecan with fluorouracil and folinic acid in metastatic pancreatic cancer after previous gemcitabine-based therapy (NAPOLI-1): a global, randomised, open-label, phase 3 trial. Lancet 387:545–557PubMedCrossRef
6.
Zurück zum Zitat Murray CJ, Vos T, Lozano R et al (2012) Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2197–2223PubMedCrossRef Murray CJ, Vos T, Lozano R et al (2012) Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2197–2223PubMedCrossRef
7.
Zurück zum Zitat Bernhard J, Dietrich D, Glimelius B et al (2010) Estimating prognosis and palliation based on tumour marker CA 19-9 and quality of life indicators in patients with advanced pancreatic cancer receiving chemotherapy. Br J Cancer 103:1318–1324PubMedPubMedCentralCrossRef Bernhard J, Dietrich D, Glimelius B et al (2010) Estimating prognosis and palliation based on tumour marker CA 19-9 and quality of life indicators in patients with advanced pancreatic cancer receiving chemotherapy. Br J Cancer 103:1318–1324PubMedPubMedCentralCrossRef
8.
Zurück zum Zitat Dale PS, Souza JW, Brewer DA (1998) Cryosurgical ablation of unresectable hepatic metastases. J Surg Oncol 68:242–245PubMedCrossRef Dale PS, Souza JW, Brewer DA (1998) Cryosurgical ablation of unresectable hepatic metastases. J Surg Oncol 68:242–245PubMedCrossRef
9.
Zurück zum Zitat Goldberg SN, Gazelle GS, Mueller PR (2000) Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol 174:323–331PubMedCrossRef Goldberg SN, Gazelle GS, Mueller PR (2000) Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol 174:323–331PubMedCrossRef
10.
Zurück zum Zitat Keane MG, Bramis K, Pereira SP, Fusai GK (2014) Systematic review of novel ablative methods in locally advanced pancreatic cancer. World J Gastroenterol 20:2267–2278 Keane MG, Bramis K, Pereira SP, Fusai GK (2014) Systematic review of novel ablative methods in locally advanced pancreatic cancer. World J Gastroenterol 20:2267–2278
11.
Zurück zum Zitat Kovach SJ, Hendrickson RJ, Cappadona CR et al (2002) Cryoablation of unresectable pancreatic cancer. Surgery 131:463–464PubMedCrossRef Kovach SJ, Hendrickson RJ, Cappadona CR et al (2002) Cryoablation of unresectable pancreatic cancer. Surgery 131:463–464PubMedCrossRef
12.
Zurück zum Zitat Sato M, Watanabe Y, Kashu Y, Hamada Y, Kawachi K (1998) Sequential percutaneous microwave coagulation therapy for liver tumor. Am J Surg 175:322–324 Sato M, Watanabe Y, Kashu Y, Hamada Y, Kawachi K (1998) Sequential percutaneous microwave coagulation therapy for liver tumor. Am J Surg 175:322–324
13.
Zurück zum Zitat Varshney S, Sewkani A, Sharma S et al (2006) Radiofrequency ablation of unresectable pancreatic carcinoma: feasibility, efficacy and safety. JOP 7:74–78PubMed Varshney S, Sewkani A, Sharma S et al (2006) Radiofrequency ablation of unresectable pancreatic carcinoma: feasibility, efficacy and safety. JOP 7:74–78PubMed
14.
Zurück zum Zitat Scheffer HJ, Vroomen LG, de Jong MC et al (2017) Ablation of locally advanced pancreatic cancer with percutaneous irreversible electroporation: results of the Phase I/II PANFIRE Study. Radiology 282:585–597PubMedCrossRef Scheffer HJ, Vroomen LG, de Jong MC et al (2017) Ablation of locally advanced pancreatic cancer with percutaneous irreversible electroporation: results of the Phase I/II PANFIRE Study. Radiology 282:585–597PubMedCrossRef
15.
Zurück zum Zitat Gao HF, Wang K, Meng ZQ et al (2013) High intensity focused ultrasound treatment for patients with local advanced pancreatic cancer. Hepatogastroenterology 60:1906–1910PubMed Gao HF, Wang K, Meng ZQ et al (2013) High intensity focused ultrasound treatment for patients with local advanced pancreatic cancer. Hepatogastroenterology 60:1906–1910PubMed
16.
Zurück zum Zitat Marinova M, Huxold HC, Henseler J et al (2018) Clinical effectiveness and potential survival benefit of US-guided high-intensity focused ultrasound therapy in patients with advanced-stage pancreatic cancer. Eur J Ultrasound 40(5):625–637 Marinova M, Huxold HC, Henseler J et al (2018) Clinical effectiveness and potential survival benefit of US-guided high-intensity focused ultrasound therapy in patients with advanced-stage pancreatic cancer. Eur J Ultrasound 40(5):625–637
17.
Zurück zum Zitat Sofuni A, Moriyasu F, Sano T et al (2014) Safety trial of high-intensity focused ultrasound therapy for pancreatic cancer. World J Gastroenterol 20:9570–9577PubMedPubMedCentralCrossRef Sofuni A, Moriyasu F, Sano T et al (2014) Safety trial of high-intensity focused ultrasound therapy for pancreatic cancer. World J Gastroenterol 20:9570–9577PubMedPubMedCentralCrossRef
18.
Zurück zum Zitat Vidal-Jove J, Perich E, del Castillo MA (2015) Ultrasound guided high intensity focused ultrasound for malignant tumors: the Spanish experience of survival advantage in stage III and IV pancreatic cancer. Ultrason Sonochem 27:703–706PubMedCrossRef Vidal-Jove J, Perich E, del Castillo MA (2015) Ultrasound guided high intensity focused ultrasound for malignant tumors: the Spanish experience of survival advantage in stage III and IV pancreatic cancer. Ultrason Sonochem 27:703–706PubMedCrossRef
19.
Zurück zum Zitat Wang K, Chen Z, Meng Z et al (2011) Analgesic effect of high intensity focused ultrasound therapy for unresectable pancreatic cancer. Int J Hyperthermia 27:101–107PubMedCrossRef Wang K, Chen Z, Meng Z et al (2011) Analgesic effect of high intensity focused ultrasound therapy for unresectable pancreatic cancer. Int J Hyperthermia 27:101–107PubMedCrossRef
20.
Zurück zum Zitat Wang K, Zhu H, Meng Z et al (2013) Safety evaluation of high-intensity focused ultrasound in patients with pancreatic cancer. Onkologie 36:88–92PubMedCrossRef Wang K, Zhu H, Meng Z et al (2013) Safety evaluation of high-intensity focused ultrasound in patients with pancreatic cancer. Onkologie 36:88–92PubMedCrossRef
21.
Zurück zum Zitat Xiong LL, Hwang JH, Huang XB et al (2009) Early clinical experience using high intensity focused ultrasound for palliation of inoperable pancreatic cancer. JOP 10:123–129PubMed Xiong LL, Hwang JH, Huang XB et al (2009) Early clinical experience using high intensity focused ultrasound for palliation of inoperable pancreatic cancer. JOP 10:123–129PubMed
22.
Zurück zum Zitat Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376PubMedCrossRef Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376PubMedCrossRef
23.
Zurück zum Zitat Fayers PM (2001) Interpreting quality of life data: population-based reference data for the EORTC QLQ-C30. Eur J Cancer 37:1331–1334PubMedCrossRef Fayers PM (2001) Interpreting quality of life data: population-based reference data for the EORTC QLQ-C30. Eur J Cancer 37:1331–1334PubMedCrossRef
24.
Zurück zum Zitat Cameron AC, Trivedi PK (2010) Microeconometrics using STATA. Stata Press, College Station Cameron AC, Trivedi PK (2010) Microeconometrics using STATA. Stata Press, College Station
25.
Zurück zum Zitat Rabe-Hesketh S, Skrondal A (2012) Multilevel and longitudinal modeling using Stata, 3rd edn. Stata Press, College Station, pp 1–2 Rabe-Hesketh S, Skrondal A (2012) Multilevel and longitudinal modeling using Stata, 3rd edn. Stata Press, College Station, pp 1–2
26.
Zurück zum Zitat Syrjala KL, Jensen MP, Mendoza ME, Yi JC, Fisher HM, Keefe FJ (2014) Psychological and behavioral approaches to cancer pain management. J Clin Oncol 32:1703–1711 Syrjala KL, Jensen MP, Mendoza ME, Yi JC, Fisher HM, Keefe FJ (2014) Psychological and behavioral approaches to cancer pain management. J Clin Oncol 32:1703–1711
27.
Zurück zum Zitat Seufferlein T, Porzner M, Heinemann V, Tannapfel A, Stuschke M, Uhl W (2014) Ductal pancreatic adenocarcinoma. Dtsch Arztebl Int 111:396–402 Seufferlein T, Porzner M, Heinemann V, Tannapfel A, Stuschke M, Uhl W (2014) Ductal pancreatic adenocarcinoma. Dtsch Arztebl Int 111:396–402
28.
29.
Zurück zum Zitat Muller-Nordhorn J, Roll S, Bohmig M et al (2006) Health-related quality of life in patients with pancreatic cancer. Digestion 74:118–125PubMedCrossRef Muller-Nordhorn J, Roll S, Bohmig M et al (2006) Health-related quality of life in patients with pancreatic cancer. Digestion 74:118–125PubMedCrossRef
30.
Zurück zum Zitat Labori KJ, Hjermstad MJ, Wester T, Buanes T, Loge JH (2006) Symptom profiles and palliative care in advanced pancreatic cancer: a prospective study. Support Care Cancer 14:1126–1133 Labori KJ, Hjermstad MJ, Wester T, Buanes T, Loge JH (2006) Symptom profiles and palliative care in advanced pancreatic cancer: a prospective study. Support Care Cancer 14:1126–1133
31.
Zurück zum Zitat Beesley VL, Janda M, Goldstein D et al (2016) A tsunami of unmet needs: pancreatic and ampullary cancer patients' supportive care needs and use of community and allied health services. Psychooncology 25:150–157PubMedCrossRef Beesley VL, Janda M, Goldstein D et al (2016) A tsunami of unmet needs: pancreatic and ampullary cancer patients' supportive care needs and use of community and allied health services. Psychooncology 25:150–157PubMedCrossRef
32.
Zurück zum Zitat Marinova M, Wilhelm-Buchstab T, Strunk H (2019) Advanced pancreatic cancer: high-intensity focused ultrasound (HIFU) and other local ablative therapies. Rofo 191:216–227PubMedCrossRef Marinova M, Wilhelm-Buchstab T, Strunk H (2019) Advanced pancreatic cancer: high-intensity focused ultrasound (HIFU) and other local ablative therapies. Rofo 191:216–227PubMedCrossRef
33.
Zurück zum Zitat Hinrichs JB, Wacker FK (2020) Locoregional and local ablative treatment options for liver tumors. Internist (Berl) 61:158–163CrossRef Hinrichs JB, Wacker FK (2020) Locoregional and local ablative treatment options for liver tumors. Internist (Berl) 61:158–163CrossRef
34.
Zurück zum Zitat Wu Y, Tang Z, Fang H et al (2006) High operative risk of cool-tip radiofrequency ablation for unresectable pancreatic head cancer. J Surg Oncol 94:392–395PubMedCrossRef Wu Y, Tang Z, Fang H et al (2006) High operative risk of cool-tip radiofrequency ablation for unresectable pancreatic head cancer. J Surg Oncol 94:392–395PubMedCrossRef
35.
Zurück zum Zitat Ruarus AH, Vroomen L, Geboers B et al (2020) Percutaneous Irreversible Electroporation in Locally Advanced and Recurrent Pancreatic Cancer (PANFIRE-2): a multicenter, prospective, single-arm, phase II study. Radiology 294:212–220PubMedCrossRef Ruarus AH, Vroomen L, Geboers B et al (2020) Percutaneous Irreversible Electroporation in Locally Advanced and Recurrent Pancreatic Cancer (PANFIRE-2): a multicenter, prospective, single-arm, phase II study. Radiology 294:212–220PubMedCrossRef
36.
Zurück zum Zitat Lee JY, Choi BI, Ryu JK et al (2011) Concurrent chemotherapy and pulsed high-intensity focused ultrasound therapy for the treatment of unresectable pancreatic cancer: initial experiences. Korean J Radiol 12:176–186PubMedPubMedCentralCrossRef Lee JY, Choi BI, Ryu JK et al (2011) Concurrent chemotherapy and pulsed high-intensity focused ultrasound therapy for the treatment of unresectable pancreatic cancer: initial experiences. Korean J Radiol 12:176–186PubMedPubMedCentralCrossRef
37.
Zurück zum Zitat Li PZ, Zhu SH, He W et al (2012) High-intensity focused ultrasound treatment for patients with unresectable pancreatic cancer. Hepatobiliary Pancreat Dis Int 11:655–660PubMedCrossRef Li PZ, Zhu SH, He W et al (2012) High-intensity focused ultrasound treatment for patients with unresectable pancreatic cancer. Hepatobiliary Pancreat Dis Int 11:655–660PubMedCrossRef
38.
Zurück zum Zitat Li YY, Sha WH, Zhou YJ, Nie YQ (2007) Short and long term efficacy of high intensity focused ultrasound therapy for advanced hepatocellular carcinoma. J Gastroenterol Hepatol 22:2148–2154 Li YY, Sha WH, Zhou YJ, Nie YQ (2007) Short and long term efficacy of high intensity focused ultrasound therapy for advanced hepatocellular carcinoma. J Gastroenterol Hepatol 22:2148–2154
39.
Zurück zum Zitat Sung HY, Jung SE, Cho SH et al (2011) Long-term outcome of high-intensity focused ultrasound in advanced pancreatic cancer. Pancreas 40:1080–1086PubMedCrossRef Sung HY, Jung SE, Cho SH et al (2011) Long-term outcome of high-intensity focused ultrasound in advanced pancreatic cancer. Pancreas 40:1080–1086PubMedCrossRef
40.
Zurück zum Zitat Marinova M, Strunk HM, Rauch M et al (2017) High-intensity focused ultrasound (HIFU) for tumor pain relief in inoperable pancreatic cancer: evaluation with the pain sensation scale (SES). Schmerz 31(1):31–39PubMedCrossRef Marinova M, Strunk HM, Rauch M et al (2017) High-intensity focused ultrasound (HIFU) for tumor pain relief in inoperable pancreatic cancer: evaluation with the pain sensation scale (SES). Schmerz 31(1):31–39PubMedCrossRef
41.
Zurück zum Zitat Strunk HM, Henseler J, Rauch M et al (2016) Clinical use of high-intensity focused ultrasound (HIFU) for tumor and pain reduction in advanced pancreatic cancer. Rofo 188:662–670PubMedCrossRef Strunk HM, Henseler J, Rauch M et al (2016) Clinical use of high-intensity focused ultrasound (HIFU) for tumor and pain reduction in advanced pancreatic cancer. Rofo 188:662–670PubMedCrossRef
42.
Zurück zum Zitat Stone P, Richardson A, Ream E, Smith AG, Kerr DJ, Kearney N (2000) Cancer-related fatigue: inevitable, unimportant and untreatable? Results of a multi-centre patient survey. Cancer Fatigue Forum. Ann Oncol 11:971–975 Stone P, Richardson A, Ream E, Smith AG, Kerr DJ, Kearney N (2000) Cancer-related fatigue: inevitable, unimportant and untreatable? Results of a multi-centre patient survey. Cancer Fatigue Forum. Ann Oncol 11:971–975
43.
Zurück zum Zitat Jacox A, Carr DB, Payne R (1994) New clinical-practice guidelines for the management of pain in patients with cancer. N Engl J Med 330:651–655PubMedCrossRef Jacox A, Carr DB, Payne R (1994) New clinical-practice guidelines for the management of pain in patients with cancer. N Engl J Med 330:651–655PubMedCrossRef
44.
Zurück zum Zitat Cherny N, Ripamonti C, Pereira J et al (2001) Strategies to manage the adverse effects of oral morphine: an evidence-based report. J Clin Oncol 19:2542–2554PubMedCrossRef Cherny N, Ripamonti C, Pereira J et al (2001) Strategies to manage the adverse effects of oral morphine: an evidence-based report. J Clin Oncol 19:2542–2554PubMedCrossRef
45.
Zurück zum Zitat Cuhls H, Mücke M, Brunsch-Radbruch A et al (2014) Schmerztherapie in der Palliativmedizin - Aktuelle Aspekte der Schmerztherapie. CME 11:7–14CrossRef Cuhls H, Mücke M, Brunsch-Radbruch A et al (2014) Schmerztherapie in der Palliativmedizin - Aktuelle Aspekte der Schmerztherapie. CME 11:7–14CrossRef
46.
Zurück zum Zitat Wong GY, Schroeder DR, Carns PE et al (2004) Effect of neurolytic celiac plexus block on pain relief, quality of life, and survival in patients with unresectable pancreatic cancer: a randomized controlled trial. JAMA 291:1092–1099PubMedCrossRef Wong GY, Schroeder DR, Carns PE et al (2004) Effect of neurolytic celiac plexus block on pain relief, quality of life, and survival in patients with unresectable pancreatic cancer: a randomized controlled trial. JAMA 291:1092–1099PubMedCrossRef
47.
Zurück zum Zitat Yan BM, Myers RP (2007) Neurolytic celiac plexus block for pain control in unresectable pancreatic cancer. Am J Gastroenterol 102:430–438PubMedCrossRef Yan BM, Myers RP (2007) Neurolytic celiac plexus block for pain control in unresectable pancreatic cancer. Am J Gastroenterol 102:430–438PubMedCrossRef
Metadaten
Titel
Improving quality of life in pancreatic cancer patients following high-intensity focused ultrasound (HIFU) in two European centers
verfasst von
Milka Marinova
Hyuliya Feradova
Maria A. Gonzalez-Carmona
Rupert Conrad
Tolga Tonguc
Marcus Thudium
Marc U. Becher
Zhou Kun
Grigor Gorchev
Slavcho Tomov
Christian P. Strassburg
Ulrike Attenberger
Hans H. Schild
Dobromir Dimitrov
Holger M. Strunk
Publikationsdatum
23.01.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 8/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07682-z

Weitere Artikel der Ausgabe 8/2021

European Radiology 8/2021 Zur Ausgabe

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.