Department of Radiology, Imperial College London, London, UK.
Cardiovasc Intervent Radiol. 2012 Dec;35(6):1531-4. doi: 10.1007/s00270-012-0363-7. Epub 2012 Feb 25.
Patients with chemotherapy-refractory liver metastases who are not candidates for surgery may be treated with focal ablation techniques with established survival benefits. Irreversible electroporation is the newest of these and has the putative advantages of a nonthermal action, preventing damage to adjacent biliary structures and bowel. This report describes the use of irreversible electroporation in a 61-year-old man with a solitary chemoresistant liver metastasis unsuitable for radiofrequency ablation as a result of its proximity to the porta hepatis. At 3 months, tumor size was decreased on computed tomography from 28 × 19 to 20 × 17 mm, representing stable disease according to the response evaluation criteria in solid tumors. This corresponded to a decrease in tumor volume size from 5.25 to 3.16 cm(3). There were no early or late complications. Chemoresistant liver metastases in the proximity of the porta hepatis that are considered to be too high a risk for conventional surgery or thermal ablation may be considered for treatment by the novel ablation technique of irreversible electroporation.
对于不适合手术的化疗耐药性肝转移患者，可采用已证实具有生存获益的局部消融技术进行治疗。不可逆电穿孔是这些技术中最新的一种，据称具有非热作用的优势，可以防止邻近胆管结构和肠道受损。本报告描述了在一名 61 岁男性中使用不可逆电穿孔的情况，该患者因靠近肝门而不适合射频消融治疗耐药性单发性肝转移。在 3 个月时，根据实体瘤反应评估标准，CT 扫描显示肿瘤大小从 28×19 减小到 20×17mm，为疾病稳定。这对应于肿瘤体积从 5.25 减小到 3.16cm³。没有出现早期或晚期并发症。对于靠近肝门、被认为常规手术或热消融风险过高的耐药性肝转移，可以考虑采用不可逆电穿孔这一新型消融技术进行治疗。
