Department of Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Hepatobiliary Pancreat Dis Int. 2010 Jun;9(3):306-11.
Radiofrequency ablation (RFA) has been suggested as a new treatment option for patients with locally advanced cancer. This study aimed to prospectively evaluate the efficacy and safety of intraoperative RFA in patients with unresectable, locally advanced, non-metastatic carcinoma of the pancreatic head.
RFA was the first step of the surgical procedure and was carried out on the mobilized pancreatic head followed by biliary by-pass and gastrojejunal-anastomosis. Intra- and post-operative morbidity and mortality, performance status, pain control, quality of life, and survival at 24 months were evaluated.
Seven patients (3 men and 4 women; median age 66 years, range 47-80 years) were studied and 4 were eligible for treatment. The RFA procedure was carried out in 3 of the 4 patients; in one patient it was not carried out because of the upstaging of the neoplasm. In all 3 patients RFA achieved complete necrosis of the lesion. A biliary fistula developed 7 days after the procedure in one patient; all 3 patients developed ascites 8.6 days (range 7-9 days) on average after RFA. All patients died respectively, at 3, 4, and 5 months after the treatment.
In our experience, RFA is a feasible procedure, but it presents a very high rate of postoperative complications. Moreover, pain control, life quality and survival rate are poor. The few data suggest no impact on survival.
射频消融(RFA)已被提议作为局部晚期癌症患者的一种新的治疗选择。本研究旨在前瞻性评估术中 RFA 在不可切除、局部晚期、非转移性胰头癌患者中的疗效和安全性。
RFA 是手术的第一步,在移动的胰头进行,随后进行胆道旁路和胃空肠吻合。评估围手术期发病率和死亡率、体能状态、疼痛控制、生活质量以及 24 个月时的生存率。
7 例患者(3 男 4 女;中位年龄 66 岁,范围 47-80 岁)入组,4 例符合治疗条件。4 例患者中有 3 例进行了 RFA 治疗;1 例由于肿瘤分期升级未进行。在所有 3 例患者中,RFA 均实现了病变的完全坏死。1 例患者在手术后 7 天出现胆瘘;所有 3 例患者在 RFA 后平均 8.6 天(范围 7-9 天)出现腹水。所有患者分别在治疗后 3、4 和 5 个月死亡。
根据我们的经验,RFA 是一种可行的治疗方法,但术后并发症发生率非常高。此外,疼痛控制、生活质量和生存率较差。为数不多的数据表明其对生存率没有影响。