Systematic Review of Irreversible Electroporation Role in Management of Locally Advanced Pancreatic Cancer
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Ablative Techniques | Target Patients | Ablation Technique | QoL Improvement | Complications |
---|---|---|---|---|
HIFU | LAPC Metastatic | Extracorporeal | Pain relief, Opioid intake, Better survival | Pancreatic fistula, gastric ulcers, pseudocyst formation, hematologic disorders |
RFA | LAPC | Percutaneous Intraoperative | Pain relief | Heat damage, Hemorragies, acute pancreatitis, pancreatic fistula, biliary or duodenal burn, vein thrombosis |
IRE | LAPC | Percutaneous Intraoperative | Pain relief, Opioid intake, Better survival | Pancreatic fistula, mild pancreatitits, vessel thrombosis, pseudoaneurysm |
Cryoablation | LAPC Metastatic | Percutaneous Intraoperative | Mild pain relief | Severe pancreatitis, bleeding, pancreatic fistula, delayed gastric emptying |
Microwave | LAPC | Percutaneous Intraoperative | Few reports | Mild pancreatitis, pancreatic fistula, minor bleeding |
References | Pts (n) | Age | T Size (cm) | Prior RT (n) | Prior Cht (n) | Technique | Complication Rate (%) | Median OS (mo) | Mortality (%) |
---|---|---|---|---|---|---|---|---|---|
Belfiore [12] | 29 | 68.5 | 4.5 | NA | NA | Percut | 0 | 14 (d) | NA |
Kluger [13] | 50 | 68.2 | 3.2 | Open | 24.5 | 12 (t) | 6 | ||
Dunkl-Jacobs [20] | 65 | NA | NA | 37 | 43 | Percut/Open | 20 | NA | NA |
Mansson [14] | 24 | 65 | 3.5 | 10 | 22 | Percut | 45.8 | 17.9 (d) | 4 |
Lambert [15] | 21 | 68.2 | 3.9 | NA | 5 | Percut/Open | 23.8 | 10 (t) | 0 |
Martin [21] | 27 | 61 | 3.0 | Percut/Open | 33 | 17.9 (d) | 4 | ||
Martin [22] | 54 | 61 | 3.2 | Open/VLS | 59.2 | 20.2 (d) | 2 | ||
Martin [23] | 200 | 62 | 2.8 | 77 | 130 | Open | 37 | 24.9 (d) | 2 |
Paiella [24] | 10 | 66 | 3 | 4 | 10 | Open | 10 | 15.3 (d) | 0 |
Vogel [25] | 15 | NA | NA | 0 | 9 | Open | 53 | 16 (d) | 13 |
Narayanan [16] | 50 | 62.5 | 3.2 | 30 | 50 | Percut | 20 | 27 (d) | 6 |
Yan [17] | 25 | 58 | 4.2 | 3 | 1 | Open | 36 | NA | 4 |
Leen [18] | 75 | 63.4 | NA | 4 | 75 | Percut | 25 | 27 (t) | 0 |
Zhang [19] | 21 | NA | 3.5 | NA | NA | Percut | nr | NA | NA |
Scheffer [26] | 25 | 61 | 4 | 0 | 13 | Percut | 40 | 17 (d) | 0 |
Trial ID | Title | Phase | Number of Patients | Countries |
---|---|---|---|---|
NCT02791503 | CROSSFIRE Trial: Cross atlantic randomized controlled trial comparing outcome in survival after systemic plus focal therapy for inoperable pancreatic carcinoma: RT vs. IRE | 2–3 | 138 | The Netherlands |
NCT03080974 | Immunotherapy and Irreversible Electroporation in the treatment of advanced pancreatic adenocarcinoma | 2 | 10 | USA |
NCT02718859 | Study of the combined therapy of IRE and Natural Killer Cells for advanced pancreatic cancer | 1–2 | 60 | China |
NCT02041936 | Evaluation of the short and intermediate term outcomes of ablation of locally advanced unresectable pancreatic cancer using the Nanoknife IRE System—A prospective study | NA | 12 | USA |
NCT03257150 | IRE for locally advanced pancreatic ductal adenocarcinoma (LEAP TRIAL): A phase I/II prospective trial | 1–2 | 47 | Canada |
NCT03105921 | IRE (Nanoknife) for the Treatment of Pancreatic Adenocarcinoma | NA | 20 | France |
NCT02674100 | AHPBA Pancreatic Irreversible electroporation (IRE) registry for pancreatic cancer | NA | 500 | USA, Japan, Taiwan, UK |
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Lafranceschina, S.; Brunetti, O.; Delvecchio, A.; Conticchio, M.; Ammendola, M.; Currò, G.; Piardi, T.; de’Angelis, N.; Silvestris, N.; Memeo, R. Systematic Review of Irreversible Electroporation Role in Management of Locally Advanced Pancreatic Cancer. Cancers 2019, 11, 1718. https://doi.org/10.3390/cancers11111718
Lafranceschina S, Brunetti O, Delvecchio A, Conticchio M, Ammendola M, Currò G, Piardi T, de’Angelis N, Silvestris N, Memeo R. Systematic Review of Irreversible Electroporation Role in Management of Locally Advanced Pancreatic Cancer. Cancers. 2019; 11(11):1718. https://doi.org/10.3390/cancers11111718
Chicago/Turabian StyleLafranceschina, Stefano, Oronzo Brunetti, Antonella Delvecchio, Maria Conticchio, Michele Ammendola, Giuseppe Currò, Tullio Piardi, Nicola de’Angelis, Nicola Silvestris, and Riccardo Memeo. 2019. "Systematic Review of Irreversible Electroporation Role in Management of Locally Advanced Pancreatic Cancer" Cancers 11, no. 11: 1718. https://doi.org/10.3390/cancers11111718