• Int J Surg · Sep 2015

    Clinical Trial

    Percutaneous CT-guided irreversible electroporation followed by chemotherapy as a novel neoadjuvant protocol in locally advanced pancreatic cancer: Our preliminary experience.

    • Maria Paola Belfiore, Francesco Michele Ronza, Francesco Romano, Giovanni Pietro Ianniello, Guido De Lucia, Concetta Gallo, Carmela Marsicano, Teresa Letizia Di Gennaro, and Giuseppe Belfiore.
    • Department of Clinical and Experimental Medicine, "F. Magrassi - A. Lanzara" Second University of Naples, Piazza Miraglia 2, 80131 Naples, Italy. Electronic address: mariapaolabelfiore@gmail.com.
    • Int J Surg. 2015 Sep 1; 21 Suppl 1: S34-9.

    IntroductionIrreversible electroporation (IRE) is a non-thermal ablation technique recently used in pancreatic cancer. In our prospective study we evaluated safety, feasibility and efficacy of a neoadjuvant protocol based on CT-guided percutaneous IRE followed by chemotherapy in patients with locally advanced pancreatic cancer (LAPC).MethodsWe performed CT-guided percutaneous IRE in 20 patients with LAPC, followed by a combination of gemcitabine (1000 mg/mq) and oxaliplatin (100 mg/mq) biweekly. Imaging follow-up was performed by a contrast enhanced CT scan at 1, 3, 6 months and then every 3 months.ResultsNo major complications occurred. Two patients died 3 and 4 months after IRE because of rapidly progressive disease. In the remaining 18 patients 6-month imaging follow-up showed a mean lesions volumetric decrease percentage of 42.89% (95% Confidence Interval: 34.90-54.88%). Thanks to lesions downstaging, three patients underwent R0 resection. At last available follow-up (mean follow-up 91 months; range 6-14), imaging showed no disease progression or post-surgical relapse in all 18 cases. The mean estimated survival was 12,950 months (95% CI: 11,570-14,332).ConclusionsOur preliminary study suggests that IRE followed by chemotherapy is safe, feasible and effective in producing local control of LAPC, with a possible downstaging effect to resectable lesions.Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

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