Department of Pancreatobiliary Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, P.R. China.
Cancer Med. 2020 Jul;9(13):4699-4710. doi: 10.1002/cam4.3119. Epub 2020 May 15.
Locally advanced pancreatic cancer (LAPC) remains a challenge for current treatments. Local destructive therapies, such as irreversible electroporation (IRE) and radiofrequency ablation (RFA), were used more and more frequently in the treatment of LAPC.
This study aimed to compare the efficacy of IRE with RFA in patients with LAPC.
From August 2015 to August 2017, 58 LAPC patients after IRE or RFA therapy, which was performed through open approach, were retrospectively reviewed. The survival outcomes after IRE (36 patients) and RFA (18 patients) were compared after propensity score matching (PSM) analysis.
Before PSM analysis, IRE after the induction chemotherapy resulted in significant higher overall survival (OS) rates and progression-free survival (PFS) rates to RFA (2-year OS, 53.5% vs 30.8%, P = .013; 2-year PFS, 28.4% vs 12.1%, P = .043). After PSM analysis, compared with RFA, the survival benefit of IRE was even more obvious, (2-year OS, 53.5% vs 27.0%, P = .010; 2-year PFS, 28.4% vs 6.4%, P = .018). For patients with tumor larger than 4 cm, IRE resulted in comparable OS and PFS between RFA and IRE while IRE also achieved better long-term OS to RFA for those with tumor smaller than 4 cm. Multivariate analysis illustrated that IRE was a favorable prognostic factor in terms of OS and PFS in patients with LAPC.
IRE after induction chemotherapy is superior to RFA after induction chemotherapy for treating LAPC patients while these two therapies have comparable efficacy for tumors which were larger than 4 cm.
局部进展期胰腺癌（LAPC）仍然是目前治疗的挑战。不可逆电穿孔（IRE）和射频消融（RFA）等局部破坏疗法在 LAPC 的治疗中越来越频繁地使用。
本研究旨在比较 IRE 和 RFA 治疗 LAPC 患者的疗效。
回顾性分析 2015 年 8 月至 2017 年 8 月间 58 例接受 IRE 或 RFA 治疗的 LAPC 患者。采用倾向评分匹配（PSM）分析比较 IRE（36 例）和 RFA（18 例）治疗后的生存结果。
在 PSM 分析之前，IRE 联合诱导化疗后总生存率（OS）和无进展生存率（PFS）明显高于 RFA（2 年 OS：53.5% vs 30.8%，P=0.013；2 年 PFS：28.4% vs 12.1%，P=0.043）。PSM 分析后，与 RFA 相比，IRE 的生存获益更为明显（2 年 OS：53.5% vs 27.0%，P=0.010；2 年 PFS：28.4% vs 6.4%，P=0.018）。对于肿瘤直径大于 4cm 的患者，IRE 与 RFA 的 OS 和 PFS 无差异，而对于肿瘤直径小于 4cm 的患者，IRE 的 OS 获益优于 RFA。多因素分析表明，IRE 是 LAPC 患者 OS 和 PFS 的有利预后因素。
IRE 联合诱导化疗治疗 LAPC 患者优于 RFA 联合诱导化疗，而对于肿瘤直径大于 4cm 的患者，两种治疗方法的疗效相当。
