胰腺癌冷冻治疗及冷冻免疫

Cryotherapy and Cryoimmunotherapy for Pancreatic Cancer

胰腺癌是预后极差的肿瘤,当前各种治疗手段效果均不佳。冷冻在各种实体瘤的治疗中已取得较好效果,但在胰腺癌治疗中的作用报道甚少。体内外实验表明冷冻可毁损肿瘤细胞,安全性好。临床研究显示:冷冻为主综合治疗中晚期胰腺癌,中位生存期达13.4～16个月,1年生存率57.5%～63.6%;安全性好,主要并发症为:胃排空障碍的发生率为0～40.9%;胰漏发生率为0～6.8%;胆漏的发生率为0～6.8%。更为重要的是,肿瘤冷冻消融后,以坏死肿瘤细胞和细胞碎片的形式,释放大量肿瘤抗原,诱导冷冻后免疫,可抑制肿瘤的生长和转移。将局部冷冻消融治疗与全身免疫治疗相结合。

The prognosis of pancreatic cancer patients is extremely poor, and the cure effects of various treatments are not quite satisfactory. Cryosurgery has achieved good results in the treatment of various solid tumors. However, little pancreatic cancer data have been reported. In vitro and In vitro experiments show that cryosurgery destroys tumor cells and has good security. Clinical studies have indicated that in the freezing-based comprehensive treatment of advanced pancreatic cancer, the median survival ranges from 13.4 months to 16 months, and the 1-year survival rate is between 57.5 % and 63.6 %. These figures indicate that cryotherapy is safe for patients. Its major complications include delayed gastric emptying （ 0 % to 40 % ）, pancreatic leakage （ 0 % to 6 % ）, and biliary leakage （ 0 % to 6.8 %）. Most importantly, after cryoablation, the tumor releases large amounts of antigens in the form of cell necrosis byproducts and debris, which induce freeze immunity and then inhibit tumor growth and metastasis. Most importantly, local cryoablation combined with systemic immunotherapy could provide new advanced cancer treatment techniques and strategies.