不可逆电穿孔同步化疗治疗局部进展性胰腺癌

Irreversible electroporation simultaneous chemotherapy for locally advanced pancreatic cancer

目的 探讨不可逆电穿孔(IRE)同步化疗治疗局部进展期胰腺癌(LAPC)的安全性及有效性。方法 对2016年10月至2018年1月收治于广州复大肿瘤医院的30例LAPC患者的临床资料进行回顾性研究,所有患者在IRE消融开始前均静脉滴注吉西他滨30 min,IRE术后2周进行常规静脉滴注吉西他滨联合替吉奥化疗方案。结果 术后90 d内未发生与IRE相关的死亡病例。中位随访时间为23.8个月(3.5~36.4个月),联合治疗后的中位总生存期为20.5个月(诊断)和17.1个月(IRE术后)。在1、3和6个月的客观反应率(ORR)分别为93.3%、83.3%、66.7%。发生了4例严重不良反应,其中2例胰腺炎、1例严重中性粒细胞减少和1例胃十二指肠动脉出血,经对症治疗后均得到缓解。结论 IRE同步化疗治疗LAPC有效且耐受性良好,为LAPC患者提供了一种潜在的治疗策略。

objective To investigated the safety and efficacy of irreversible electroporation (IRE)simultaneous chemotherapy for locally advanced pancreatic cancer.Methods The clinical data of 30 LAPC(locally advanced pancreatic cancer) patients treated in Guangzhou Fuda Cancer Hospital from Oct.2016 to Jan.2018 were retrospectively analyzed.All patients received a 30 minutes intravenous infusion of gemcitabine immediately before the start of IRE ablation.Routine intravenous Gemcitabine combined with S-1 were performed 2 weeks after IRE.Results There were no IRE-related deaths within 90 days.Median follow-up period was 23.8 months (3.5-36.4 months),the median overall survival (OS) was 20.5 months (from diagnosis)and 17.1 months (from IRE).The objective response rate (ORR) of the combination therapy at 1,3 and 6 months were 93.3%,83.3%and 66.7%,respectively.Four major adverse reactions were occurred,including two cases of pancreatitis,one case of severe neutropenia,and one case of gastroduodenal artery hemorrhage,all of them were resolved after symptomatic treatment.Conclusion The combination therapy model was effective and welltolerated,which offered a potential therapeutic strategy for LAPC patients.