Percutaneous CT-guided irreversible electroporation followed by chemotherapy as a novel neoadjuvant protocol in locally advanced pancreatic cancer: Our preliminary experience

INTERNATIONAL JOURNAL OF SURGERY

卷:21

Article

Belfiore, Maria Paola¹  Ronza, Francesco Michele²  Romano, Francesco³  Ianniello, Giovanni Pietro⁴  De Lucia, Guido⁴  Gallo, Concetta⁵  Marsicano, Carmela⁵  Di Gennaro, Teresa Letizia⁶  Belfiore, Giuseppe² 

[1] F Magrassi A Lanzara Second Univ Naples, Dept Clin & Expt Med, I-80131 Naples, Italy

[2] S Anna S Sebastiano Hosp, Dept Diagnost Imaging, I-81100 Caserta, Italy

[3] Univ Naples 2, Dept Informat, I-80131 Naples, Italy

[4] S Anna S Sebastiano Hosp, Dept Oncol, I-81100 Caserta, Italy

[5] S Anna S Sebastiano Hosp, Dept Anaesthesiol & Rianimat, I-81100 Caserta, Italy

[6] Univ Naples 2, Dept Anesthesiol Surg & Emergency Sci, I-80131 Naples, Italy

关键词: IRE;    Irreversible electroporation;    Pancreatic cancer;    Gemcitabine;    Oxaliplatin;    Downstaging;   

DOI  :  10.1016/j.ijsu.2015.06.049

来源: Elsevier

【 摘 要 】

Introduction: Irreversible electroporation (IRE) is a non-thermal ablation technique recently used in pancreatic cancer. In our prospective study we evaluated safety, feasibility and efficacy of a neoadjuvant protocol based on CT-guided percutaneous IRE followed by chemotherapy in patients with locally advanced pancreatic cancer (LAPC). Methods: We performed CT-guided percutaneous IRE in 20 patients with LAPC, followed by a combination of gemcitabine (1000 mg/mq) and oxaliplatin (100 mg/mq) biweekly. Imaging follow-up was performed by a contrast enhanced CT scan at 1, 3, 6 months and then every 3 months. Results: No major complications occurred. Two patients died 3 and 4 months after IRE because of rapidly progressive disease. In the remaining 18 patients 6-month imaging follow-up showed a mean lesions volumetric decrease percentage of 42.89% (95% Confidence Interval: 34.90e54.88%). Thanks to lesions downstaging, three patients underwent R0 resection. At last available follow-up (mean follow-up 91 months; range 6-14), imaging showed no disease progression or post-surgical relapse in all 18 cases. The mean estimated survival was 12,950 months (95% CI: 11,570-14,332). Conclusions: Our preliminary study suggests that IRE followed by chemotherapy is safe, feasible and effective in producing local control of LAPC, with a possible downstaging effect to resectable lesions. (C) 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

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