Percutaneous irreversible electroporation “acceptably safe” for pancreatic adenocarcinoma treatment

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Govindarajan Narayanan

A study, published in the Journal of Vascular and Interventional Radiology suggests that percutaneous image-guided irreversible electroporation of unresectable locally advanced pancreatic adenocarcinoma is associated with a satisfactory safety profile.

The research, which included 50 patients (23 women), set out to assess the safety profile of irreversible electroporation and as a secondary objective, to determine the overall survival of patients who were treated with the procedure.

Irreversible electroporation uses short, repetitive, non-thermal high-energy pulses of electricity to destroy cancer cells. It has been reported to have been used intraoperatively, laparoscopically or percutaneously

All patients included in the study had biopsy-proven, unresectable locally advanced pancreatic adenocarcinoma and received computed tomography (CT)–guided irreversible electroporation. They all had had prior chemotherapy (one to five lines), and 60% of patients had had prior radiation therapy. Follow-up included CT at one month and at three-month intervals thereafter.

Govindarajan Narayanan, chairman, Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, USA, and colleagues reported that there were no treatment-related deaths and no 30-day mortality. However, serious adverse events including abdominal pain, sepsis and gastric leak occurred in 20% of the patients.

The investigators also reported that the median overall survival was 27 months from time of diagnosis and 14.2 months from time of receiving the interventional radiology procedure. Patients with tumours that were smaller than 3cm (n=24) had significantly longer median overall survival when compared to  patients with tumours that were larger than 3cm: 33.8 vs. 22.7 months from time of diagnosis (p=0.002) and 16.2 vs. 9.9 months from time of  irreversible electroporation (p=0.031). Tumour size was confirmed as the only independent predictor of overall survival at multivariate analysis, they further reported.