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Percutaneous CT-Guided Cryoablation for Pain Palliation and Local Treatment Effect in Unresectable Pancreatic Ductal Adenocarcinoma: A Pilot Single-Center Case Series
by
, , , ,
Claudio Pusceddu
1
,
Claudio Carrubba
2,*,
Pierluigi Maria Rinaldi
1, 
Claudio Cau
1,
Felice D’Antuono
2,
Francesco Giurazza
2,
Raffaella Niola
2 and
Salvatore Marsico
3 1
Department of Radiology, Mater Olbia Hospital, SS 125 Orientale Sarda, 07026 Olbia, Italy
2
Vascular and Interventional Radiology Department, Cardarelli Hospital, Via Antonio Cardarelli 9, 80131 Naples, Italy
3
Department of Radiology, Hospital del Mar, Passeig Marítim 25, 08003 Barcelona, Spain
*
Author to whom correspondence should be addressed.
Cancers 2026, 18(11), 1724; https://doi.org/10.3390/cancers18111724
Submission received: 28 April 2026
/
Revised: 18 May 2026
/
Accepted: 21 May 2026
/
Published: 25 May 2026
(This article belongs to the Section Methods and Technologies Development)
Simple Summary
Pain is a major problem in patients with unresectable pancreatic cancer, and often requires opioid treatment, which may reduce quality of life. This pilot single-center case series evaluated computed tomography-guided cryoablation as a palliative, tumor-directed treatment in 11 patients with painful unresectable pancreatic ductal adenocarcinoma. The procedure was technically successful in all patients, and no major complications were observed. Pain intensity decreased after treatment, and all patients showed a reduction in opioid requirement during early follow-up. These preliminary findings suggest that computed tomography-guided cryoablation may be a feasible palliative option in selected patients with painful unresectable pancreatic cancer and may support further prospective research in this field.
Abstract
Background/Objectives: Pain is one of the most disabling symptoms in patients with unresectable pancreatic ductal adenocarcinoma (PDAC), having a major impact on quality of life, functional status, and tolerance to oncologic treatment. Percutaneous computed tomography (CT)-guided cryoablation may provide tumor-directed pain palliation in selected patients. This study aimed to evaluate the safety and palliative clinical benefit of percutaneous CT-guided cryoablation in patients with painful unresectable PDAC. Methods: This retrospective single-center pilot case series included 11 consecutive patients with painful unresectable PDAC treated with percutaneous CT-guided cryoablation between January 2022 and May 2024. Primary endpoints were change in visual analogue scale (VAS) score and reduction in analgesic requirement. Secondary endpoints included technical success, adverse events, supportive clinical outcomes, imaging evolution, progression status, and survival. Results: Technical success was achieved in all procedures (11/11, 100%). No major procedure-related complications occurred; minor adverse events were observed in 3/11 patients (27.3%). Mean VAS score decreased from 6.72 ± 1.56 at baseline to 3.45 ± 1.44 at 1 month, 2.54 ± 1.29 at 3 months, 2.27 ± 1.43 at 6 months, and 1.60 ± 1.07 at 12 months. At 1 month, all patients showed a reduction of at least 3 VAS points. A reduction in analgesic requirement was documented in all patients during early follow-up, with complete opioid discontinuation in 5/11 patients (45.5%). At 1-month CT, residual enhancement was present in 9/11 patients (81.8%), although with an estimated 50–80% reduction in enhancing tumor burden. Observed survival proportions at 6 and 12 months were 90.9% and 72.7%, respectively. Conclusions: Percutaneous CT-guided cryoablation appears to be a feasible palliative option for selected patients with painful unresectable PDAC, with meaningful pain relief, opioid sparing, acceptable short-term safety, and exploratory imaging evidence of local cytoreductive effect. Further prospective studies are warranted.
