Jiang Tian'An, Zhao Qiyu, Tian Guo, Chen Xinhua, Wu Liming
Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China.
Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China.
Exp Ther Med. 2019 Sep;18(3):2243-2249. doi: 10.3892/etm.2019.7780. Epub 2019 Jul 17.
Metastatic retroperitoneal tumors constitute an end-stage disease with poor prognosis that represents a heavy global health burden. The present study aimed to explore the efficacy of irreversible electroporation ablation (IRE) therapy in patients with end-stage retroperitoneal tumors. Between April 2016 and September 2017, three patients with unresectable retroperitoneal malignant tumors were enrolled. Among these cases, ultrasound (US)-guided IRE was palliatively performed for targeting 3 tumors (1 tumor per patient) located around the abdominal aorta. Post-treatment contrast-enhanced US (CEUS) and contrast-enhanced computed tomography (CECT) scans were subsequently performed to evaluate the area adjacent to the ablation zone and determine the prognosis. During the follow-up, the cases experienced a reduction of pain (mean score of 5.8 decreased to 2.2, based on the visual analogue scale), and had an overall survival rate ranging from 2 to 11 months. Case 1 remained alive at the time of submission of this study, but case 2 died within 2 months and case 3 within 11 months due to liver metastases of the primary tumor. At the 3-week follow-up, the CEUS image for case 1 exhibited a contrast defect with a sufficient ablation margin, in accordance with the CECT at 1.5 months following IRE, exhibiting complete tumor necrosis without contrast enhancement. Overall, these results suggest that US-guided percutaneous IRE may be effective in the treatment of end-stage retroperitoneal tumors. However, further studies are required to substantiate the conclusions of the present study. The present clinical trial was registered at clinicaltrials.gov (ID: NCT02822066) on June 20th, 2016.
转移性腹膜后肿瘤是一种预后较差的终末期疾病，给全球健康带来沉重负担。本研究旨在探讨不可逆电穿孔消融（IRE）疗法对终末期腹膜后肿瘤患者的疗效。2016年4月至2017年9月，纳入了3例无法切除的腹膜后恶性肿瘤患者。在这些病例中，对位于腹主动脉周围的3个肿瘤（每位患者1个肿瘤）进行了超声（US）引导下的IRE姑息治疗。随后进行了治疗后对比增强超声（CEUS）和对比增强计算机断层扫描（CECT），以评估消融区附近区域并确定预后。在随访期间，这些病例的疼痛有所减轻（根据视觉模拟量表，平均评分从5.8降至2.2），总生存期为2至11个月。在提交本研究时，病例1仍然存活，但病例2在2个月内死亡，病例3在11个月内死于原发性肿瘤的肝转移。在3周的随访中，病例1的CEUS图像显示有足够消融边缘的对比剂缺损，与IRE后1.5个月的CECT结果一致，显示肿瘤完全坏死且无对比剂增强。总体而言，这些结果表明，US引导下的经皮IRE可能对终末期腹膜后肿瘤的治疗有效。然而，需要进一步的研究来证实本研究的结论。本临床试验于2016年6月20日在clinicaltrials.gov上注册（ID：NCT02822066）。
