Irreversible electroporation in the treatment of locally advanced pancreatic cancer
Authors:
P. Záruba 1; D. Hoskovec 2; J. Lacman 3; J. Hořejš 4; Z. Krška 2; M. Ryska 1,5
Authors‘ workplace:
Chirurgická klinika 2. LF Univerzity Karlovy, ÚVN, Praha
přednosta: prof. MUDr. M. Ryska, CSc.
1; 1. chirurgická klinika VFN v Praze 1 a 1. LF Univerzity Karlovy
přednosta: prof. MUDr. Z. Krška, CSc.
2; Radiodiagnostiké oddělení, ÚVN Praha
primář: MUDr. T. Belšan, CSc.
3; Radiodiagnostická klinika VFN v Praze 1 a 1. LF Univerzity Karlovy
přednosta: prof. MUDr. J. Daneš, CSc.
4; Fakulta zdravotníctva a sociálnej práce, Trnavská Univerzita, Trnava
děkan: prof. MUDr. J. Slaný, CSc.
5
Published in:
Rozhl. Chir., 2015, roč. 94, č. 12, s. 504-509.
Category:
Review
Overview
Introduction:
Irreversible electroporation (IRE) is a quite novel method of tissue ablation. Its mechanism of action that does not use thermal energy is the most important feature of the method. Current experience with IRE in animal studies and in clinical practice are summarized in the paper. In particular, the paper is focused on using IRE in locally advanced pancreatic carcinoma.
Method:
The basic principle of IRE is that it causes micropores in the phospholipid membrane of cells. This leads to an impairment of cellular homeostasis and programmed cell death – apoptosis. Because of absence of protein denaturation this method spares tubular structures like vessels and ducts. This is the key feature that allows to use IRE in the pancreas where common thermic ablative procedures cannot be used for difficult anatomic circumstances and resulting injury of surrounding structures.
Pre-clinical and clinical studies:
The ability to spare vascular structures and ducts was confirmed in many animal studies. Subsequently, IRE was safely utilized also in human liver, pancreas, lung and kidneys. IRE in the treatment of advanced pancreatic cancer: Most experience with IRE ablation has been gathered for locally advanced pancreatic carcinoma where clinical studies published in the recent 5 years have provided encouraging results.
Conclusion:
Irreversible electroporation is a safe method used to decrease tumour mass in pancreatic cancer. Further studies are needed to determine its therapeutic efficiency.
Key words:
irreversible electroporation − advanced pancreatic cancer
Sources
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2015 Issue 12
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