Local ablation of pancreatic tumors: State of the art and future perspectives  

作　　者：Vincenza Granata Roberta Grassi Roberta Fusco Andrea Belli Raffaele Palaia Gianpaolo Carrafiello Vittorio Miele Roberto Grassi Antonella Petrillo Francesco Izzo 

机构地区：[1]Department of Radiology,Istituto Nazionale Tumori–IRCCS-Fondazione G.Pascale,Naples 80131,Italy [2]Department of Radiology,Universitàdegli Studi della Campania Luigi Vanvitelli,Naples 80127,Italy [3]Department of Surgery,Istituto Nazionale Tumori–IRCCS-Fondazione G.Pascale,Naples 80131,Italy [4]Department of Surgery,Universitàdegli Studi di Milano,Milano 20122,Italy [5]Italian Society of Medical and Interventional Radiology SIRM,SIRM Foundation Milan 20122,Italy [6]Department of Emergency Radiology,San Camillo Hospital,Firenze 50139,Italy

出　　处：《World Journal of Gastroenterology》2021年第23期3413-3428,共16页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Currently,the technologies most commonly used to treat locally advanced pancreatic cancer are radiofrequency ablation(RFA),microwave ablation,and irreversible(IRE)or reversible electroporation combined with low doses of chemotherapeutic drugs.AIM To report an overview and updates on ablative techniques in pancreatic cancer.METHODS Several electronic databases were searched.The search covered the years from January 2000 to January 2021.Moreover,the reference lists of the found papers were analysed for papers not indexed in the electronic databases.All titles and abstracts were analysed.RESULTS We found 30 studies(14 studies for RFA,3 for microwave therapy,10 for IRE,and 3 for electrochemotherapy),comprising 1047 patients,which were analysed further.Two randomized trials were found for IRE.Percutaneous and laparotomy approaches were performed.In the assessed patients,the median maximal diameter of the lesions was in the range of 2.8 to 4.5 cm.All series included patients unfit for surgical treatment,but Martin et al assessed a subgroup of patients with borderline resectable tumours who underwent resection with margin attenuation with IRE.Most studies administered chemotherapy prior to ablative therapies.However,several studies suggest that the key determinant of improved survival is attributable to ablative treatment alone.Nevertheless,the authors suggested chemotherapy before local therapies for several reasons.This strategy may not only downstage a subgroup of patients to curative-intent surgery but also support to recognize patients with biologically unfavourable tumours who would likely not benefit from ablation treatments.Ablation therapies seem safe based on the 1047 patients assessed in this review.The mortality rate ranged from 1.8%to 2%.However,despite the low mortality,the reported rates of severe post procedural complications ranged from 0%-42%.Most reported complications have been self-limiting and manageable.Median overall survival varied between 6.0 and 33 mo.Regarding the technical success

关 键 词：Pancreatic cancer Ablation treatment Radiofrequency ablation Microwave ablation IRREVERSIBLE ELECTROCHEMOTHERAPY 

分 类 号：R735.9[医药卫生—肿瘤]