Ma Yang-Yang, Shi Juan-Juan, Chen Ji-Bing, Xu Ke-Chen, Niu Li-Zhi
Central Laboratory, Fuda Cancer Hospital, Jinan University, Guangzhou 510665, Guangdong Province, China.
Department of Oncology, Fuda Cancer Hospital, Jinan University, Guangzhou 510665, Guangdong Province, China.
World J Clin Cases. 2020 Jan 26;8(2):390-397. doi: 10.12998/wjcc.v8.i2.390.
Pancreatic cancer has a poor prognosis; 40%-50% of patients have liver metastases at the time of initial diagnosis and only 15%-20% undergo surgical resection. Irreversible electroporation (IRE) is a new, non-thermal local ablation method for solid tumors, which can induce cell membrane permeabilization, resulting in unrecoverable nanoscale perforation and apoptotic cell death without damaging the structural components of tissues.
We report the case of a 66-year-old female patient with liver metastasis from pancreatic cancer with a pathological diagnosis of poorly differentiated adenocarcinoma. Carbohydrate antigen 19-9 was elevated to 420.3 U/mL. Computed tomography showed a pancreas mass of 2.7 cm × 2.5 cm and single liver metastasis of 1.4 cm × 1.1 cm in the S6 area. The patient underwent IRE and arterial infusion chemotherapy and received tegafur. The therapeutic effect of the combination treatment has been evaluated as complete response. To date, the patient has survived for > 12 mo and is receiving tegafur as maintenance therapy (at the time this case report was written).
IRE plus arterial infusion chemotherapy and tegafur may be synergistic, providing a reference for treating liver metastasis from pancreatic cancer.
胰腺癌预后较差；40% - 50%的患者在初诊时已有肝转移，仅15% - 20%的患者接受手术切除。不可逆电穿孔（IRE）是一种用于实体瘤的新型非热局部消融方法，可诱导细胞膜通透性增加，导致不可恢复的纳米级穿孔和凋亡性细胞死亡，而不损害组织的结构成分。
我们报告了一例66岁女性胰腺癌肝转移患者，病理诊断为低分化腺癌。糖类抗原19 - 9升高至420.3 U/mL。计算机断层扫描显示胰腺肿块大小为2.7 cm×2.5 cm，肝脏S6区有一个1.4 cm×1.1 cm的单发转移灶。该患者接受了IRE和动脉灌注化疗，并接受替加氟治疗。联合治疗的疗效评估为完全缓解。迄今为止，患者已存活超过12个月，目前正在接受替加氟维持治疗（撰写本病例报告时）。
IRE联合动脉灌注化疗和替加氟可能具有协同作用，为治疗胰腺癌肝转移提供了参考。
