Published online Nov 26, 2020. doi: 10.12998/wjcc.v8.i22.5564
Peer-review started: August 12, 2020
First decision: August 22, 2020
Revised: August 25, 2020
Accepted: September 26, 2020
Article in press: September 26, 2020
Published online: November 26, 2020
Locally advanced pancreatic cancer (LAPC) is a common malignant digestive system tumor that ranks as the fourth leading cause of cancer-related death in the world. The prognosis of LAPC is poor even after standard treatment. Irreversible electroporation (IRE) is a novel ablative strategy for LAPC. Several studies have confirmed the safety of IRE. To date, no prospective studies have been performed to investigate the therapeutic efficacy of conventional gemcitabine (GEM) plus concurrent IRE.
To compare the therapeutic efficacy between conventional GEM plus concurrent IRE and GEM alone for LAPC.
From February 2016 to September 2017, a total of 68 LAPC patients were treated with GEM plus concurrent IRE n = 33) or GEM alone n = 35). Overall survival (OS), progression free survival (PFS), and procedure-related complications were compared between the two groups. Multivariate analyses were performed to identify any prognostic factors.
There were no treatment-related deaths. The technical success rate of IRE ablation was 100%. The GEM + IRE group had a significantly longer OS from the time of diagnosis of LAPC (19.8 mo vs 9.3 mo, P < 0.0001) than the GEM alone group. The GEM + IRE group had a significantly longer PFS (8.3 mo vs 4.7 mo, P < 0.0001) than the GEM alone group. Tumor volume less than 37 cm3 and GEM plus concurrent IRE were identified as significant favorable factors for both the OS and PFS.
Gemcitabine plus concurrent IRE is an effective treatment for patients with LAPC.
Core Tip: Locally advanced pancreatic cancer (LAPC) is a common malignant digestive system tumor with poor prognosis. Gemcitabine (GEM) is currently used as a first-line chemotherapy for treatment of LAPC; however, the overall outcome was poor. Irreversible electroporation (IRE) is a novel, non-thermal ablation technology that uses high voltage electrical pulses to induce pore formation, resulting in cell apoptosis. We found that GEM plus concurrent IRE resulted in significantly prolonging overall survival compared with chemotherapy alone. Therefore, GEM plus concurrent IRE has a synergistic effect on the clinical treatment of LAPC.