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Repeated irreversible electroporation in a locally advanced pancreatic cancer

https://doi.org/10.17709/2410-1893-2022-9-4-11

Abstract

It is reasonable to consider the technical possibility and oncological feasibility of the local tumor destruction in patients with locally advanced pancreatic cancer (PCa). Irreversible electroporation (IRE) is a non-thermal method of local tumor ablation, which uses non-thermal energy of high-voltage ultrashort electric fields localized between electrodes to create nanopores in the cellular wall with the following cellular death. The zone of impact can be accurately predicted using the location of the electrodes. A fairly clear and controlled ablation boundary without a clinically significant zone of perifocal tissue damage reduces the risk of accidental injury to the wall of a hollow organ. The method is based on a change in the permeability of the cell membrane and the development of apoptosis, which allows to act directly on the ducts and the great vessels infiltrated by the tumor without a high risk of damage. The presented case shows that IRE is advisable to use as a part of the combined treatment of patients with locally advanced PCa. There were no complications observed after the IRE. Radiological evaluations and pathologic reports showed an adequate long-term local control. Also, good results were obtained in the overall life expectancy, given that we are talking about unresectable ductal adenocarcinoma of the pancreas. The patient passed away in 39 months from the beginning of the treatment and in 26 months from the initial IRE. In case of local relapse, repeated electroporation with a good long-term result is also possible. The time to progression exceeded eleven months after electroporation performed for a local relapse. According to magnetic resonance imaging, both locoregional relapse and distant liver metastases were detected. The patient lived 16 months after a repeated IRE session and died of pulmonary embolism on the background of chemotherapy. Favorable prognostic factors are the presence of an objective response to previous conservative treatment, compliance with the parameters of electroporation, complete inclusion of tumor infiltration in the affected area.

About the Authors

A. N. Polyakov
N. N. Blokhin National Medical Research Center of Oncology
Russian Federation

Alexandr N. Polyakov – Cand. Sci. (Med.), senior researcher of the oncology department of surgical treatment methods No. 7 (tumors of the hepatopancreatobiliary zone)

24 Kashirskoye sh., Moscow 115478

SPIN: 9924-0256,

AuthorID: 764535.

Scopus Author ID: 57190413973



D. V. Podluzhnyi
N. N. Blokhin National Medical Research Center of Oncology
Russian Federation

Danila V. Podluzhnyi – Cand. Sci. (Med.), head of the oncology department of surgical treatment methods No. 7 (tumors of the hepatopancreatobiliary zone)

Moscow

SPIN: 3537-3436,

AuthorID: 583879,

Scopus Author ID: 6506558213



N. E. Kudashkin
N. N. Blokhin National Medical Research Center of Oncology
Russian Federation

Nikolay E. Kudashkin – Cand. Sci. (Med.), the senior researcher of the oncology department of surgical treatment methods No. 7 (tumors of the hepatopancreatobiliary zone)

Moscow

SPIN: 3574- 8344,

AuthorID: 865983,

ResearcherID: R-8764-2019,

Scopus Author ID: 54885375500



I. S. Bazin
N. N. Blokhin National Medical Research Center of Oncology
Russian Federation

Igor S. Bazin – leading researcher of the second chemotherapeutic department

Moscow

SPIN: 2186-5878,

AuthorID: 266861,

ResearchID: J-6618-2017,

Scopus Author ID: 000326249341



B. M. Medvedeva
N. N. Blokhin National Medical Research Center of Oncology
Russian Federation

Bela M. Medvedeva – Dr. Sci. (Med.), head of radiology department, scientific research institute of clinical and experimental radiology

Moscow

SPIN: 1160-2169,

AuthorID: 583878,

Scopus Author ID: 56563956800



A. Yu. Syskova
City Clinical Oncological Hospital No. 1
Russian Federation

Anna Yu. Syskova – medical oncologist, department of chemotherapy No. 2

Moscow

SPIN: 1676-6072,

AuthorID: 1118447



D. M. Kantieva
N. N. Blokhin National Medical Research Center of Oncology
Russian Federation

Dayana M. Kantieva – oncologist of the second chemotherapeutic department

Moscow

ResearchID: GLV-5759-2022



Yu. I. Patyutko
N. N. Blokhin National Medical Research Center of Oncology
Russian Federation

Yuriy I. Patyutko – Dr. Sci. (Med.), chief adviser of the oncology department of surgical treatment methods No. 7 (tumors of the hepatopancreatobiliary zone)

Moscow

AuthorID: 137980



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For citations:


Polyakov A.N., Podluzhnyi D.V., Kudashkin N.E., Bazin I.S., Medvedeva B.M., Syskova A.Yu., Kantieva D.M., Patyutko Yu.I. Repeated irreversible electroporation in a locally advanced pancreatic cancer. Research and Practical Medicine Journal. 2022;9(4):114-122. https://doi.org/10.17709/2410-1893-2022-9-4-11

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ISSN 2410-1893 (Online)