Abstract
Radiofrequency ablation (RFA), particularly endoscopic ultrasound-guided RFA (EUS-RFA), has emerged as a promising minimally invasive approach for the treatment of pancreatic cancer, especially in patients with locally advanced or unresectable disease. This review outlines recent technological developments in EUS-RFA, including innovations in energy delivery systems, probe design, and real-time thermal monitoring, which have improved the precision and safety of the procedure. Clinical studies combining EUS-RFA with chemotherapy have demonstrated encouraging outcomes, with improvements in overall survival, progression-free survival, tumor necrosis, and symptom control compared to chemotherapy alone. Additionally, RFA-induced tumor antigen release and modulation of the tumor microenvironment suggest a potential synergistic role with immunotherapy. Despite its promise, the widespread adoption of EUS-RFA is limited by a lack of large-scale randomized controlled trials and standardized treatment protocols.