Percutaneous Radiofrequency Ablation of Unresectable Locally Advanced Pancreatic Cancer: Preliminary Results

Aim: The objective of this study was to evaluate the efficacy of percutaneous radiofrequency ablation of locally advanced pancreatic cancer located in the pancreatic body. Materials and Methods: Patients with biopsy-proven locally advanced pancreatic adenocarcinoma were considered for percutaneous radiofrequency ablation. Postprocedural computed tomography studies and Ca19.9 tumor marker evaluation were performed at 24 hours and 1 month. At computed tomography, treatment effect was evaluated by excluding the presence of complications. The technical success of the procedure is defined at computed tomography as the achievement of tumoral ablated area. Results: Twenty-three patients have been included in the study. Five of the 23 patients were excluded. At computed tomography, the mean size of the intralesional postablation necrotic area was 32 mm (range: 15-65 mm). Technical success of the procedure has been obtained in 16 (93%) of the 18 cases. None of the patients developed postprocedural complications. Mean Ca19.9 serum levels 1 day before, 1 day after, and 1 month after the procedure were 285.8 U/mL (range: 16.6-942.0 U/mL), 635.2 U/mL (range: 17.9-3368.0 U/mL), and 336.0 U/mL (range: 7.0-1400.0 U/mL), respectively. Follow-up duration was less than 6 months for 11 patients and more than 6 months for 7 patients. At the time of the draft of this article, the mean survival of the patients included in the study was 185 days (range: 62-398 days). Conclusion: Percutaneous radiofrequency ablation of locally advanced adenocarcinoma has a high technical success rate and is effective in cytoreduction both at imaging and laboratory controls.

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Computed tomography findings after radiofrequency ablation in locally advanced pancreatic cancer

Abdominal Radiology ◽

10.1007/s00261-018-1519-y ◽

2018 ◽

Vol 43 (10) ◽

pp. 2702-2711 ◽

Cited By ~ 1

Author(s):

Steffi J. E. Rombouts ◽

Tyche C. Derksen ◽

Chung Y. Nio ◽

Richard van Hillegersberg ◽

Hjalmar C. van Santvoort ◽

...

Keyword(s):

Computed Tomography ◽

Pancreatic Cancer ◽

Radiofrequency Ablation ◽

Locally Advanced ◽

Advanced Pancreatic Cancer ◽

Locally Advanced Pancreatic Cancer

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Open radiofrequency ablation as upfront treatment for locally advanced pancreatic cancer: Requiem from a randomized controlled trial

Pancreatology ◽

10.1016/j.pan.2021.06.005 ◽

2021 ◽

Author(s):

Isabella Frigerio ◽

Salvatore Paiella ◽

Emilio Barbi ◽

Roberto Bianco ◽

Gianni Boz ◽

...

Keyword(s):

Pancreatic Cancer ◽

Randomized Controlled Trial ◽

Radiofrequency Ablation ◽

Controlled Trial ◽

Locally Advanced ◽

Advanced Pancreatic Cancer ◽

Locally Advanced Pancreatic Cancer ◽

Randomized Controlled

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Radiofrequency ablation of Locally Advanced Pancreatic Cancer: Immunostimulation Patterns

HPB ◽

10.1016/j.hpb.2019.10.1523 ◽

2019 ◽

Vol 21 ◽

pp. S766

Author(s):

A. Giardino ◽

G. Innamorati ◽

R. Girelli ◽

I. Frigerio ◽

P. Regi ◽

...

Keyword(s):

Pancreatic Cancer ◽

Radiofrequency Ablation ◽

Locally Advanced ◽

Advanced Pancreatic Cancer ◽

Locally Advanced Pancreatic Cancer

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Computed tomography findings after RFA in locally advanced pancreatic cancer

HPB ◽

10.1016/j.hpb.2017.02.304 ◽

2017 ◽

Vol 19 ◽

pp. S135

Author(s):

S. Rombouts ◽

T. Derksen ◽

C. Nio ◽

I. Molenaar ◽

M. van Leeuwen

Keyword(s):

Computed Tomography ◽

Pancreatic Cancer ◽

Locally Advanced ◽

Advanced Pancreatic Cancer ◽

Locally Advanced Pancreatic Cancer

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Radiofrequency ablation for locally advanced pancreatic cancer: SMAD4 analysis segregates a responsive subgroup of patients

Langenbeck s Archives of Surgery ◽

10.1007/s00423-017-1627-0 ◽

2017 ◽

Cited By ~ 1

Author(s):

Salvatore Paiella ◽

Giuseppe Malleo ◽

Ivana Cataldo ◽

Clizia Gasparini ◽

Matteo De Pastena ◽

...

Keyword(s):

Pancreatic Cancer ◽

Radiofrequency Ablation ◽

Locally Advanced ◽

Advanced Pancreatic Cancer ◽

Locally Advanced Pancreatic Cancer

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Intraoperative electrochemotherapy in locally advanced pancreatic cancer: Results and impact on quality of life. a single center experience.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e16731 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e16731-e16731

Author(s):

Mariacristina Di Marco ◽

Claudio Ricci ◽

Riccardo Carloni ◽

Elisa Grassi ◽

Stefania De Lorenzo ◽

...

Keyword(s):

Quality Of Life ◽

Pancreatic Cancer ◽

Disease Progression ◽

Locally Advanced ◽

Advanced Pancreatic Cancer ◽

The Body ◽

Locally Advanced Pancreatic Cancer ◽

Long Term Results ◽

The Mean

e16731 Background: Locally advanced pancreatic cancer (LAPC) is usually treated with chemoradiotherapy with poor results, thus additional therapies have been proposed. Of the latter, electrochemotherapy (ECT) represents a non-thermal ablation method, which combines the administration of chemotherapeutic drugs with permeabilizing electric pulses for cell membrane electroporation. The present study is the first to assess the short and long-term results, and the quality of life of the patients who underwent ECT for LAPC. Methods: Observational study of patients affected by LAPC who underwent intraoperative ECT after chemoradiotherapy. The inclusion criteria were: 1- patients with LAPC (defined according to the National Comprehensive Cancer Network 2019), 2- previous chemoradiotherapy and 3- absence of disease progression at restaging. Data at diagnosis and at restaging were collected for each patient. The Quality of life was evaluated using the Euro Quality of Life Group Association Questionnaire (EQ-5D-5L). The questionnaire was administered to all patients before and after ECT. Results: From May 25, 2018 to November 26, 2019 five patients underwent ECT: in 4 cases, the tumors were located in the head and, in one, in the body of the pancreas. Preoperative chemotherapy consisted mainly of 6 cycles of modified folfirinox, while the radiotherapy consisted of 54 Gy (27 fractions). At restaging, the serum value of CA 19-9 and tumor size were reduced; however, the vascular involvement did not change. No downstaging was recorded. Intravenous bleomycin 15,000IU/m2 was given as a bolus, the ECT procedure was performed using at least 4 needles with a mean duration time of 27 minutes, (range 15-40). No postoperative mortality or major complications were reported. The mean length of stay was 8 days (range 5-14). Four patients were alive and well at the end of the study while one patient died from disease progression. The mean follow-up was 20.8 months (range 9-34) from diagnosis and 9.4 months (range 2-19) from ECT. The quality of life was good (EQ-5D-5L scale > 50 in all cases) and there was improvement in pain/discomfort with respect to the pre-treatment period in 3 out of 5 patients. Conclusions: Electrochemotherapy can be considered a simple, feasible and safe palliative additional treatment in LAPC without progression after chemoradiotherapy, and it seems to allow a good quality of life and pain improvement.

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