The efficacy of combination of induction chemotherapy and irreversible electroporation ablation for patients with locally advanced pancreatic adenocarcinoma

J Surg Oncol. 2018 Jul;118(1):31-36. doi: 10.1002/jso.25110. Epub 2018 Jun 7.

Abstract

Background and objectives: Irreversible electroporation (IRE) is a non-thermal focal therapy that utilizes high voltage electric pulses to permanently rupture the cellular membrane and induce cell death. In this multi-center study, we evaluated the safety and efficacy of IRE in patients with locally advanced pancreatic cancer (LAPC).

Methods: From 2012 to 2015, we performed laparotomic and laparoscopic IRE in a total of 70 patients with stage III LAPC. Either gemcitabine-based or TS-1 (Tegafur, Gimeracil, and Oteracil) chemotherapy was applied for at least 3 months before the IRE.

Results: No IRE-related deaths occurred. A median follow-up of 28.1 months showed that six patients (8.6%) experienced local recurrence and 24 (34%) experienced distant progression. The overall median survival from the time of treatment was 22.6 months, and the progression-free survival (PFS) was 15.4 months. The overall survival in the patients who used gemcitabine-based reagents was 19.1 months and that of those who used TS-1 was 28.7 months. The PFS for these two groups were 13.2 months and 26.4 months; the difference is significant.

Conclusions: Our study suggests that IRE is safe and effective for the control of LAPC. We surmise that the addition of IRE to a chemotherapy regimen may provide a survival advantage.

Keywords: TS-1; chemotherapy; gemcitabine; irreversible electroporation; locally advanced pancreatic cancer.

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / surgery
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Catheter Ablation / methods*
  • Chemotherapy, Adjuvant
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Disease-Free Survival
  • Drug Combinations
  • Electrochemotherapy / methods*
  • Fluorouracil / administration & dosage
  • Gemcitabine
  • Humans
  • Induction Chemotherapy
  • Laparotomy / methods
  • Oxonic Acid / administration & dosage
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / surgery*
  • Pyridines / administration & dosage
  • Survival Rate
  • Tegafur / administration & dosage

Substances

  • Drug Combinations
  • Pyridines
  • tegafur-gimeracil-oteracil
  • Deoxycytidine
  • Tegafur
  • Oxonic Acid
  • Fluorouracil
  • Gemcitabine