Yeung Enoch S L, Chung Max W Y, Wong Keedon, Wong Clement Y K, So Enoch C T, Chan Albert C Y
Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.
Hong Kong Med J. 2014 Aug;20(4):313-6. doi: 10.12809/hkmj134190. Epub 2014 Jun 6.
OBJECTIVE. To investigate the clinical efficacy and safety of irreversible electroporation for ablation of liver tumour in humans. DATA SOURCES. The PubMed and MEDLINE databases were systematically searched. STUDY SELECTION. Clinical research published in English in the last 10 years until October 2013 that address clinical issues related to irreversible electroporation of human liver tumours were selected. "Liver tumor", "local ablative therapy", and "irreversible electroporation" were used as the search terms. DATA EXTRACTION AND SYNTHESIS. The data extracted for this review was analysed by the authors, with a focus on the clinical efficacy and the safety of irreversible electroporation. The complete response rates look promising, ranging from 72% to 100%, except in one study in a subgroup of liver tumours in which the complete response rate was only 50% that was likely due to the inclusion of larger-size tumours. In one study, the local recurrence rate at 12 months was approximately 40%. As for the safety of irreversible electroporation, there were only a few reported complications (cardiac arrhythmia, pneumothorax, and electrolyte disturbance) that were mostly transient and not serious. There was no reported mortality related to the use of irreversible electroporation. CONCLUSION. Irreversible electroporation is a potentially effective liver tumour ablative therapy that gives rise to only mild and transient side-effects. Further studies with better patient selection criteria and longer follow-up are needed to clarify its role as a first-line liver tumour treatment modality.
目的。探讨不可逆电穿孔用于人体肝肿瘤消融的临床疗效及安全性。
数据来源。系统检索了PubMed和MEDLINE数据库。
研究选择。选取2003年10月至2013年10月期间发表的英文临床研究，这些研究涉及与人体肝肿瘤不可逆电穿孔相关的临床问题。检索词为“肝肿瘤”、“局部消融治疗”和“不可逆电穿孔”。
数据提取与综合。作者对本次综述提取的数据进行了分析，重点关注不可逆电穿孔的临床疗效和安全性。除一项研究中肝肿瘤亚组的完全缓解率仅为50%（可能是由于纳入了较大尺寸的肿瘤）外，完全缓解率前景良好，范围在72%至100%之间。在一项研究中，12个月时的局部复发率约为40%。至于不可逆电穿孔的安全性，仅报告了少数并发症（心律失常、气胸和电解质紊乱），大多为短暂性且不严重。未报告与使用不可逆电穿孔相关的死亡病例。
结论。不可逆电穿孔是一种潜在有效的肝肿瘤消融治疗方法，仅产生轻微和短暂的副作用。需要通过更好的患者选择标准和更长时间的随访进行进一步研究，以明确其作为一线肝肿瘤治疗方式的作用。
