TY - JOUR
TI - Irreversible Electroporation (IRE) Combined With Chemotherapy Increases
Survival in Locally Advanced Pancreatic Cancer (LAPC)
AU - Oikonomou, Dimitrios
AU - Karamouzis, Michalis V.
AU - Moris, Dimitrios
AU - and Dimitrokallis, Nikolaos
AU - Papamichael, Demetris
AU - Kountourakis,
AU - Panteleimon
AU - Astras, Georgios
AU - Davakis, Spyridon
AU - Papalampros,
AU - Alexandros
AU - Schizas, Dimitrios
AU - Petrou, Athanasios S. and
AU - Felekouras, Evangelos
JO - AMERICAN JOURNAL OF CLINICAL ONCOLOGY - CANCER CLINICAL TRIALS
PY - 2021
VL - 44
TODO - 7
SP - 325-330
PB - Lippincott, Williams & Wilkins
SN - 0277-3732
TODO - 10.1097/COC.0000000000000826
TODO - pancreatic cancer; LAPC; IRE; irreversible electroporation
TODO - Objectives: Locally advanced pancreatic cancer (LAPC) is found in about
40% of patients with pancreatic cancer. Irreversible electroporation
(IRE) is a nonthermal ablative technique that provides an alternative in
patients with LAPC and can be safely combined with chemotherapy.
Materials and Methods: From 2015 until October of 2019, we performed
laparotomic IRE in a total of 40 patients with stage III LAPC. The
median age of these patients was 65.2 years (range: 46 to 81 y), and the
median tumor size was 3.8 cm (range: 2 to 5.2 cm). 33 of 40 patients
were treated preoperatively with FOLFIRINOX or nab-paclitaxel plus
gemcitabine and in case of disease control, IRE was performed, whereas
in 7 patients, IRE was performed without previous chemotherapy. Results:
All patients were treated successfully with IRE as the tumor evaluation
showed no disease progression after the completion of induction
chemotherapy. No IRE-related deaths occurred. Two major grade III
complications were reported: pancreatic fistula grade A in 8 patients
and 3 patients diagnosed with delayed gastric emptying. Up to October
31, 2019, the median overall survival (OS) of all patients was 24.2
months (range: 6 to 36 mo), and the median progression-free survival was
10.3 months (range: 3 to 24 mo). After the completion of IRE, 30
patients (75%) continued with adjuvant chemotherapy. Fifteen patients
(37%) have >24 months OS and 3 patients (8%) have reached 36 months OS
and are still alive. Conclusion: The combination of chemotherapy with
IRE, which is a safe and effective procedure, may result in a survival
benefit for patients with LAPC.
ER -