Irreversible electroporation combined with chemotherapy for unresectable pancreatic carcinoma: a prospective cohort study
Authors Liu S, Qin Z, Xu J, Zeng J, Chen J, Niu L, Xu M
Received 6 September 2018
Accepted for publication 12 January 2019
Published 18 February 2019 Volume 2019:12 Pages 1341—1350
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 5
Editor who approved publication: Dr Takuya Aoki
Shupeng Liu,1,2,* Zilin Qin,1,* Jiongyuan Xu,1 Jianying Zeng,1 Jibing Chen,1 Lizhi Niu,1 Meng Xu2
1Department of Oncology, Fuda Cancer Hospital, Jinan University, Guangzhou 510665, China; 2Department of Oncology, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
*These authors contributed equally to this work
Objective: We aimed to determine the safety and efficacy of irreversible electroporation (IRE) combined with chemotherapy for unresectable pancreatic carcinoma (stage III/IV).
Methods: We prospectively enrolled 54 patients (30 men; median age 61.0 years; range 41–73 years) undergoing IRE with or without chemotherapy for pancreatic cancer between July 2015 and August 2016. Kaplan–Meier estimates were used to analyze progression-free survival (PFS) and overall survival (OS). Safety was assessed based on the occurrence of adverse events.
Results: All patients successfully underwent IRE. Major IRE-related complications were observed in four patients (7.4%). Gastrointestinal hemorrhage only developed in cases undergoing IRE via the open method, and was successfully managed with interventional embolization and/or vascular ligation. Any minor complications in the cases were alleviated within 14 days after symptomatic treatment. Overall, the performance status score decreased from 1.06 to 0.89 at 3 months after IRE (P<0.05). Among those with stage III disease, after a median follow-up of 18.8 months (range 9.6–28.7 months), the median OS from diagnosis was 16.2 and 20.3 months in the IRE and IRE + Chemo groups, respectively. Among those with stage IV disease, after a median follow-up of 13.3 months (range 3.7–23.1 months), the median OS from diagnosis was 11.6 and 13.56 months in the IRE and IRE + Chemo groups, respectively. The OS was significantly poorer in the IRE group than in the IRE + Chemo group (log-rank test, P=0.0398).
Conclusion: Patients with pancreatic carcinoma could benefit from IRE, which improved the OS in certain patients who had also undergone chemotherapy. Although some severe complications were noted, IRE was generally well tolerated.
Keywords: pancreatic carcinoma, irreversible electroporation, ablation, progression-free survival, overall survival
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