Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, 1275, York Avenue, 10065 New York, NY, USA.
Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, 1275, York Avenue, 10065 New York, NY, USA; Department of Radiology, Tenon Hospital, 4, rue de la Chine, 75020 Paris, France.
Diagn Interv Imaging. 2017 Sep;98(9):609-617. doi: 10.1016/j.diii.2017.07.007. Epub 2017 Aug 30.
Focal treatment with radiofrequency, microwave and cryoablation has been increasingly used for the treatment of tumors in patients who cannot undergo surgical resection and in select patients with early stage or oligometastatic disease. Each of these ablation modalities has a unique working principle and biophysics underlying the ablative effect, which largely determines the clinical indication for its application. Irreversible electroporation, a relatively new ablation technique with a predominantly nonthermal cell killing mechanism has emerged as an alternative treatment technique for tumors that are contraindicated for thermal ablation because of safety or efficacy considerations. Here, established thermal ablation techniques are compared with irreversible electroporation for treatment of tumors in the lung, liver, kidney and bone, and rationale is provided to guide selection of the most appropriate technique for each clinical setting.
射频、微波和冷冻消融的局部治疗已越来越多地用于不能进行手术切除的患者以及具有早期或寡转移疾病的特定患者的肿瘤治疗。这些消融方式中的每一种都具有独特的工作原理和消融效果的生物物理学基础，这在很大程度上决定了其应用的临床适应证。不可逆电穿孔是一种相对较新的消融技术，其主要的细胞杀伤机制为非热机制，已成为由于安全性或疗效考虑而不适合热消融的肿瘤的替代治疗技术。在这里，将比较已确立的热消融技术与不可逆电穿孔在肺、肝、肾和骨肿瘤治疗中的应用，并提供指导选择最适合每个临床环境的技术的基本原理。
