[1]牛立志,曾健滢,张怡湜,等.不可逆电穿孔消融治疗胰腺癌的安全性及近期疗效观察[J].介入放射学杂志,2016,(03):225-230.
　NIU Li- zhi,ZENG Jian- ying,ZHANG Yi- shi,et al.Irreversible electroporation ablation therapy for pancreatic adenocarcinoma： observation of its safety and short- term effect[J].journal interventional radiology,2016,(03):225-230.
点击复制

不可逆电穿孔消融治疗胰腺癌的安全性及近期疗效观察 ()

PDF下载中关闭

分享到：

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2016年03期
页码:
225-230
栏目:
非血管介入
出版日期:
2016-03-25

文章信息/Info

Title:
Irreversible electroporation ablation therapy for pancreatic adenocarcinoma： observation of its safety and short- term effect
作者:
牛立志;  曾健滢;  张怡湜;  梁 冰;  周 亮;  方 刚;  李书英;  李忠海;  李蓉蓉;  陈继冰;  李朝龙;  王建南;  李海波;  穆 峰;  徐克成
Author(s):
NIU Li- zhi;  ZENG Jian- ying;  ZHANG Yi- shi;  LIANG Bing;  ZHOU Liang;  FANG Gang;  LI Shu- ying;  LI Zhong- hai;  LI Rong- rong;  CHEN Ji- bing;  LI Chao- long;  WANG Jian- nan;  LI Hai- bo;  MU Feng;  XU Ke- cheng
Fuda Cancer Hospital， School of Medicine， Ji’nan University， Guangzhou， Guangdong Province 510665， China
关键词:
【关键词】 不可逆电穿孔;  胰腺癌;  近期疗效
文献标志码:
A
摘要:
【摘要】 目的 使用不可逆电穿孔（IRE）消融技术治疗不可手术切除性局部进展胰腺癌，观察该技术治疗胰腺癌的安全性和疗效。方法 前瞻性观察IRE消融术后30 d内不良反应并按照mRECIST标准评价术后（30±7） d客观疗效。结果 共12例患者接受治疗，IRE手术均顺利完成，术后30 d内不良反应有穿刺点疼痛（5例，占41.7%）、恶心呕吐（3例，占25.0%）、咳嗽、术后低血糖、低钾血症、胃壁和十二指肠水肿各2例，占16.7%、胃瀦留、发热及胸闷气促各1例，8.3%，经对症治疗后好转，未见治疗相关性大出血、胆漏或胰漏等严重并发症。术后24 h、7 d血液淀粉酶与术前相比，差异无统计学意义（P>0.05）。术后（30±7） d评价效果：完全缓解（CR）1例，部分缓解（PR）9例，稳定（SD）2例，肿瘤缓解率（CR+PR）为83.3%。结论 IRE消融治疗不可手术切除性胰腺癌，不良反应轻，安全性高，近期疗效显著。远期疗效有待进一步观察。

参考文献/References:

［1］ Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015［J］. CA Cancer J Clin, 2015, 65: 5- 29.
［2］ Baron TH, Kozarek RA. Preoperative biliary stents in pancreatic cancer proceed with caution［J］. N Engl J Med, 2010, 362: 170- 172.
［3］ Heinemann V, Boeck S, Hinke A, et al. Meta- analysis of randomized trials: evaluation of benefit from gemcitabine- based combination chemotherapy applied in advanced pancreatic cancer［J］. BMC Cancer, 2008, 8: 1- 11.
［4］ Wolff RA. Chemotherapy for pancreatic cancer: from metastatic disease to adjuvant therapy［J］. Cancer J, 2007, 13: 175- 184.
［5］ 吕少诚， 顾万清， 梁雨荣， 等． 不同外科治疗策略在晚期胰腺癌中的疗效分析［J］． 中华医学杂志， 2015， 95： 89- 92．
［6］ Bower M, Sherwood L, Li Y, et al. Irreversible electroporation of the pancreas: definitive local therapy without systemic effects［J］. J Surg Oncol, 2011, 104: 22- 28.
［7］ Neal RE 2nd, Garcia PA, Robertson JL, et al. Experimental characterization of intrapulse tissue conductivity changes for electroporation［J］. Conf Proc IEEE Eng Med Biol Soc, 2011, 2011: 5581- 5584.
［8］ Long G, Bakos G, Shires PK, et al. Histological and finite element analysis of cell death due to irreversible electroporation［J］. Technol Cancer Res Treat, 2014: 13: 561- 569.
［9］ Dunki- Jacobs EM, Philips P, Martin RC. Evaluation of resistance as a measure of successful tumor ablation during irreversible electroporation of the pancreas［J］. J Am Coll Surg, 2014, 218: 179- 187.
［10］ Trotti A, Colevas AD, Setser A, et al. CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment［J］. Semin Radiat Oncol, 2003, 13: 176- 181.
［11］ Llovet JM, Di Bisceglie AM, Bruix JA, et al. Design and endpoints of clinical trials in hepatocellular carcinoma［J］. J Natl Cancer Inst, 2008, 100: 698- 711.
［12］ 唐 葵， 涂苏林， 梁颖清， 等． 2项肿瘤标志物检测在氩氦刀冷冻治疗晚期胰腺癌中的作用［J］． 检验医学与临床， 2013， 10： 2646- 2647．
［13］ Chauffert B, Mornex F, Bonnetain F, et al. Phase Ⅲ trial comparing intensive induction chemoradiotherapy（60 Gy, infusional 5- FU and intermittent cisplatin） followed by maintenance gemcitabine with gemcitabine alone for locally advanced unresectable pancreatic cancer. Definitive results of the 2000- 01 FFCD/SFRO study［J］. Ann Oncol, 2008, 19: 1592- 1599.
［14］ Wilkowski R, Boeck S, Ostermaier S, et al. Chemoradiotherapy with concurrent gemcitabine and cisplatin with or without sequential chemotherapy with gemcitabine/cisplatin vs chemoradiotherapy with concurrent 5- fluorouracil in patients with locally advanced pancreatic cancer: a multi- centre randomised phaseⅡstudy［J］. Br J Cancer, 2009, 101: 1853- 1859.
［15］ 朱宝华． 胰腺癌射频消融治疗［J］． 中外健康文摘， 2012， 9： 212．
［16］ Davalos RV, Mir LM, Rubinsky B. Tissue ablation with irreversible electroporation［J］. Ann Biomed Eng, 2005, 33: 223- 231.
［17］ Charpentier KP, Wolf F, Noble L, et al. Irreversible electroporation of the pancreas in swine: a pilot study［J］. HPB（Oxford）, 2010, 12: 348- 351.
［18］ 孙 钢． 不可逆电穿孔技术消融肿瘤研究进展［J］． 介入放射学杂志， 2015， 24： 277- 281．
［19］ 梁 冰， 牛立志， 曾健滢， 等． 不可逆电穿孔消融兔胆囊侧肝脏病理学观察［J］． 介入放射学杂志， 2014， 23： 320- 324．
［20］ Ball C, Thomson KR, Kavnoudias H. Irreversible electroporation: a new challenge in“out of operating theater” anesthesia［J］. Anesth Analg, 2010, 110: 1305- 1309.
［21］ Kasivisvanathan V, Thapar A, Oskrochi Y, et al. Irreversible electro- poration for focal ablation at the porta hepatis［J］. Cardiovasc Intervent Radiol, 2012, 35: 1531- 1534.
［22］ Thomson KR, Cheung W, Ellis SJ, et al. Investigation of the safety of irreversible electroporation in humans［J］. J Vas Interv Radiol , 2011, 22: 611- 621.
［23］ Fanta J, Horak P, Marvan J, et al. The NanoKnife and two successful cases of intracavitary irreversible electroporation of main bronchus tumours［J］. Rozhl Chir, 2012, 91: 625- 630.
［24］ Pech M, Janitzky A, Wendler JJ, et al. Irreversible electroporation of renal cell carcinoma: a first- in- man phase I clinical study［J］. Cardiovasc Intervent Radiol, 2011, 34: 132- 138.
［25］ Wendler JJ, Pech M, Porsch M, et al. Urinary tract effects after multifocal nonthermal irreversible electroporation of the kidney: acute and chronic monitoring by magnetic resonance imaging, intravenous urography and urinary cytology［J］. Cardiovasc Intervent Radiol, 2012, 35: 921- 926.
［26］ Narayanan G, Hosein PJ, Arora GA, et al. Percutaneous irreversible electroporation for downstaging and control of unresectable panc- reatic adenocarcinoma［J］. J Vasc Interv Radiol, 2012, 23: 1613- 1621.
［27］ Martin RC. Irreversible electroporation of locally advanced pan- creatic head adenocarcinoma［J］. J Gastrointest Surg, 2013, 17: 1850- 1856.
［28］ Bagla S, Papadouris D. Percutaneous irreversible electroporation of surgically unresectable pancreatic cancer: a case report［J］. J Vasc Interv Radiol, 2012, 23: 142- 145.
［29］ Martin RC, Kwon D, Chalikonda S, et al. Treatment of 200 locally advanced（stage Ⅲ） pancreatic adenocarcinoma patients with irreversible electroporation: safety and efficacy［J］. Ann Surg, 2015, 262: 486- 494.

相似文献/References:

[1]谢涵芬,姜淑德,刘德成,等.逆行胰胆管造影对胰腺肿瘤的诊断意义[J].介入放射学杂志,1992,(01):40.
[2]方心华,王淦森.应用国产XG500毫安X线机开展肿瘤介入性治疗的体会[J].介入放射学杂志,1993,(01):38.
[3]许建华.贝郎埋入式化疗导管介绍[J].介入放射学杂志,1996,(03):152.
[4]宋 琦,刘 玉,王忠敏,等.125Ｉ放射性粒子组织间植入治疗人胰腺癌裸鼠移植瘤的有效性研究[J].介入放射学杂志,2010,(10):795.
　SONG Qi,LIU Yu,WANG Zhong-min,et al.The effectiveness of 125I seed interstitial brachytherapy for transplantation tumor of human pancreatic carcinoma in nude mice: an experiment in vivo[J].journal interventional radiology,2010,(03):795.
[5]孙 钢.不可逆电穿孔技术消融肿瘤研究进展 [J].介入放射学杂志,2015,(04):277.
　SUN Gang..Irreversible electroporation technology for ablation treatment of tumors： recent progress in research [J].journal interventional radiology,2015,(03):277.
[6]洪立立,郭 志,邢文阁,等.不同功率高强度聚焦超声治疗人胰腺癌移植瘤初步实验研究[J].介入放射学杂志,2015,(07):612.
　HONG Li- li,GUO Zhi,XING Wen- ge,et al.Different acoustic power of high- intensity focused ultrasound for the treatment of human pancreatic xenograft tumor： preliminary experimental study[J].journal interventional radiology,2015,(03):612.
[7]胡曙东,谌业荣,刘 玉,等.能谱CT早期评价125I粒子植入治疗胰腺癌效果实验研究[J].介入放射学杂志,2015,(12):1086.
　HU Shu-dong,CHEN Ye-rong,LIU Yu,et al.Application of spectral CT imaging in making early evaluation of the effect of 125I particle interstitial brachytherapy for pancreatic carcinoma： an experimental study[J].journal interventional radiology,2015,(03):1086.
[8]牛立志,曾健滢,罗小美,等.胃癌术后复发性病变的不可逆电穿孔消融1例[J].介入放射学杂志,2016,(01):50.
　NIU Li- zhi,ZENG Jian- ying,LUO Xiao- mei,et al.Irreversible electroporation ablation for postoperative recurrent lesions of gastric cancer： report of one case[J].journal interventional radiology,2016,(03):50.
[9]李辉,张洁,唐军.吉西他滨经动脉固定速率泵入治疗晚期胰腺癌的临床应用[J].介入放射学杂志,2016,(06):506.
　LI Hui,ZHANG Jie,TANG Jun..Clinical application of arterial infusion of gemcitabine by using a pump with fixed injection rate in treating advanced pancreatic cancer [J].journal interventional radiology,2016,(03):506.
[10]刘 钦,丁晓毅,王忠敏,等.CT引导下不可逆电穿孔治疗肝门部胆管细胞癌1例[J].介入放射学杂志,2016,(08):717.
　LIU Qin,DING Xiao-yi,WANG Zhong-min,et al.CT-guided irreversible electroporation for the treatment of hepatic hilar cholangiocarcinoma: report of one case [J].journal interventional radiology,2016,(03):717.

备注/Memo

备注/Memo:
（收稿日期：２０１5-０9-3０）
（本文编辑：俞瑞纲）
更新日期/Last Update: 2016-03-22