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不可切除胰腺癌的消融治疗

Ablation treatments in unresectable pancreatic cancer.

作者信息

Paiella Salvatore, De Pastena Matteo, Romeo Francesco, D'onofrio Mirko, Fontana Martina, Pea Antonio, De Marchi Giulia, Crinò Stefano F, Bassi Claudio, Salvia Roberto

机构信息

Unit of General and Pancreatic Surgery, Pancreas Institute, Policlinico GB Rossi, University of Verona, Verona, Italy -

Unit of General and Pancreatic Surgery, Pancreas Institute, Policlinico GB Rossi, University of Verona, Verona, Italy.

出版信息

Minerva Chir. 2019 Jun;74(3):263-269. doi: 10.23736/S0026-4733.18.07881-1. Epub 2019 Jan 2.

Abstract

Ablation treatments have been increasingly applied as an alternative treatment for unresectable locally advanced pancreatic cancer (LAPC). The goal of LAPC therapy is surgical resection with negative margins (R0); however, that can be achieved only in a minority of patients and only following neoadjuvant treatment. Ablation might be useful for those patients with unresectable LAPC that do not progress towards metastatic stage and do not experience a true downstaging. Indeed, some LAPC that tend to grow locally, might be the subgroup of tumors that could benefit from ablation. Experience is necessary to select patients and the technique to adopt, since serious or fatal complications can occur. This review aims to discuss the role of ablation treatments in LAPC, with a unique focus on radiofrequency ablation and irreversible electroporation.

摘要

消融治疗已越来越多地被用作不可切除的局部晚期胰腺癌(LAPC)的替代治疗方法。LAPC治疗的目标是实现切缘阴性的手术切除(R0);然而,只有少数患者能够实现这一目标,且只有在接受新辅助治疗后才行。消融对于那些不可切除的LAPC患者可能有用,这些患者未进展至转移阶段且未真正实现降期。实际上,一些倾向于局部生长的LAPC可能是可从消融中获益的肿瘤亚组。选择患者和采用的技术需要经验,因为可能会发生严重或致命的并发症。本综述旨在讨论消融治疗在LAPC中的作用,特别关注射频消融和不可逆电穿孔。

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