Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti n.9, 40138, Bologna, Italy.
Department of Haematology and Oncology (DIMES), Alma Mater Studiorum, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Updates Surg. 2020 Dec;72(4):1089-1096. doi: 10.1007/s13304-020-00782-x. Epub 2020 May 12.
Locally advanced pancreatic cancer (LAPC) is usually treated with chemoradiotherapy with poor results. The aim of the study was to assess whether intraoperative electrochemotherapy could be proposed as additional therapy in treating LAPC.
Observational study of patients affected by LAPC who underwent intraoperative electrochemotherapy (ECT) after chemoradiotherapy. Data at diagnosis, at restaging and short and long-term outcomes, including assessment of quality of life, were collected for each patient.
Five patients underwent ECT: in four cases, the tumours were located in the head and, in one, in the body of the pancreas. Preoperative chemotherapy consisted mainly of six cycles of modified Folfirinox. At restaging, the serum value of carbohydrate antigen (Ca 19-9) and tumour size were reduced; however, the vascular involvement did not change. No downstaging was recorded. The ECT procedure was performed using at least four needles with a mean duration time of 27 min (range 15-40). No postoperative mortality or major complications were reported. The mean length of stay (LOS) was 8 days (range 5-14). Four patients were alive and well at the end of the study, while one patient died from disease progression. The mean follow-up was 20.8 months (range 9-34) from diagnosis and 9.4 months (range 2-19) from ECT. The quality of life was good and there was improvement in pain/discomfort.
Electrochemotherapy could be proposed as a simple, feasible and safe palliative additional treatment in LAPC without progression after chemoradiotherapy. It seems to allow a good quality of life and pain improvement.
局部晚期胰腺癌（LAPC）通常采用放化疗治疗，但效果不佳。本研究旨在评估术中电化学治疗（ECT）是否可作为 LAPC 患者放化疗后辅助治疗的一种选择。
对接受过放化疗后行术中 ECT 的 LAPC 患者进行观察性研究。收集每位患者的诊断时、重新分期时以及短期和长期结果的数据，包括生活质量评估。
5 例患者接受了 ECT：4 例肿瘤位于胰头部，1 例位于胰体部。术前化疗主要采用改良 Folfirinox 方案 6 个周期。重新分期时，血清碳水化合物抗原（Ca 19-9）值和肿瘤大小降低，但血管侵犯未改变，无降期。ECT 过程至少使用 4 根针，平均持续时间 27 分钟（15-40 分钟）。无术后死亡或重大并发症。平均住院时间（LOS）为 8 天（5-14 天）。研究结束时，4 例患者存活且状态良好，1 例患者因疾病进展死亡。从诊断到 ECT 的平均随访时间为 20.8 个月（9-34 个月），从诊断到 ECT 的平均随访时间为 9.4 个月（2-19 个月）。生活质量良好，疼痛/不适有所改善。
在 LAPC 患者接受放化疗后疾病无进展时，ECT 可作为一种简单、可行且安全的姑息性附加治疗方法。它似乎可以提高生活质量并缓解疼痛。
