Electroporation boosts survival in pancreatic cancer

Last Updated: 2015-09-21

By David Douglas

NEW YORK (Reuters Health) - Addition of irreversible electroporation (IRE) prolongs survival, according to findings in patients with locally advanced pancreatic cancer.

As Dr. Robert C.G. Martin, told Reuters Health by email, "These results demonstrate that IRE should be considered in the multidisciplinary care of locally advanced pancreatic cancer after induction chemotherapy and in conjunction with radiation therapy."

In the September issue of the Annals of Surgery, Dr. Martin, of the University of Louisville, Kentucky, and colleagues noted that the approach uses high-voltage pulses to induce permanent cell membrane porosity, leading to permanent cell death without collagenous structure destruction.

IRE treatment has been successfully performed intraoperatively, laparoscopically, and percutaneously.

To investigate its impact, the team studied 150 patients who underwent IRE alone and 50 who had pancreatic resection plus IRE for margin enhancement. All had induction chemotherapy, and 52% also received chemoradiation therapy for a median of six months before IRE.

Thirty-seven percent of patients sustained complications, with a median grade of 2. The median length of hospital stay was six days and after a median follow-up of 29 months, six patients had experienced local recurrence. Overall survival ranged from 4.9 to 85 months.

"The appropriate and precise use of IRE in appropriately selected patients," the investigators wrote, can result in a median overall survival, "which is nearly double the survival rate with the best new chemotherapy and chemoradiotherapy."

The researchers call for further studies but conclude that IRE "substantially prolonged survival compared with historical controls. These results suggest that ablative control of the primary tumor may prolong survival."

SOURCE: http://bit.ly/1Fbg61C

Ann Surg 2015.