不可逆电穿孔胰腺癌消融临床应用的系统分析  

System Analysis of Clinical Application of Irreversible Electroporation for Pancreatic Cancer

作　　者：林益游 包家立 陈新华 LIN Yiyou;BAO Jiali;CHEN Xinhua(Zhejiang Provincial Key Laboratory of Pulsed Power Translational Medicine,Hangzhou Zhejiang 311100,China;Research Team of Biophysics and Medical Engineering,Zhejiang Provincial Key Laboratory of Bioelectromagnetics,School of Medicine,Zhejiang University,Hangzhou Zhejiang 310058,China;Division of Hepatobiliary and Pancreatic Surgery,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou Zhejiang 310003,China)

机构地区：[1]浙江省脉冲电场技术医学转化重点实验室,浙江杭州311100 [2]浙江大学医学院浙江省生物电磁学重点实验室生物物理与医学工程研究组,浙江杭州310058 [3]浙江大学医学院附属第一医院肝胆胰外科,浙江杭州310003

出　　处：《中国医疗设备》2023年第5期44-48,69,共6页China Medical Devices

基　　金：传染病防治国家科技重大专项课题(2018ZX10301201-002)。

摘　　要：目的通过系统分析探讨不可逆电穿孔技术(Irreversible Electroporation,IRE)对胰腺癌消融的有效性和安全性,为临床使用IRE治疗胰腺癌提供证据。方法检索PubMed、Web of Science、Cochrane Library、Embase、Scopus、中国知网、万方数据库、维普数据库和中华医学期刊全文数据库,纳入IRE技术治疗胰腺癌的随机对照试验和临床对照试验,检索时限均为建库至2022年12月。根据纳入与排除标准,2位研究者独立筛选文献、提取数据和评价纳入研究的方法学质量,使用RevMan 5.4软件进行Meta分析。结果共纳入8个研究,其中5个研究报告了安全性。Meta分析显示IRE技术联合化疗对胰腺癌患者治疗后,完全消融率和12月生存率均优于单独化疗组,差异具有统计学意义(P<0.05);IRE联合化疗组不良反应发生率也显著低于单纯化疗组,且差异具有统计学意义(P<0.05)。结论IRE联合化疗治疗胰腺癌的有效性及安全性相较于单纯化疗组具有显著优势。由于本研究纳入研究样本量较少,一定程度上降低了结果的可靠性,未来仍需进一步验证IRE技术对胰腺癌的疗效和安全性。Objective To investigate the efficacy and safety of irreversible electroporation(IRE)for pancreatic cancer ablation by systematic analysis,in order to provide evidence for the clinical use of IRE for pancreatic cancer.Methods PubMed,Web of Science,Cochrane Library,Embase,Scopus,CNKI,Wanfang Database,VIP database and Chinese Medical Journal full-text database were searched by computer.Randomized controlled trials and controlled clinical trials involving IRE technology for pancreatic cancer were included.The retrieval time was from the establishment of the database to December 2022.Meta-analysis was performed by using RevMan 5.4 software after two researchers screened literature,extracted data,and evaluated the methodological quality of included studies according to inclusion and exclusion criteria.Results A total of 8 studies were included,5 of which reported safety.Meta-analysis showed that the complete ablation rate and 12-month survival rate of IRE combined with chemotherapy for pancreatic cancer were significantly higher than those of chemotherapy alone(P<0.05).Meanwhile,the adverse reactions of IRE combined with chemotherapy were also significantly lower than those in chemotherapy alone group(P<0.05).Conclusion IRE combined with chemotherapy is more effective and safe than other therapies in the treatment of pancreatic cancer with fewer adverse reactions.Due to lower quantity of superior inclusion studies,which reduces the reliability of the results of this study to varying degrees.Therefore,it is still necessary to further verify the efficacy and safety of irreversible electroporation for pancreatic cancer.

关 键 词：不可逆电穿孔技术 胰腺癌 有效性 安全性 META分析 

分 类 号：R197.39[医药卫生—卫生事业管理] R454.1[医药卫生—公共卫生与预防医学]