Wang Jinlin, Wang Yun, Zhao Yuchong, Wu Xiaoli, Zhang Min, Hou Wei, Chen Qian, Cheng Bin
Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Gastroenterology and Hepatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Gastroenterology and Hepatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ann Palliat Med. 2021 Feb;10(2):1842-1850. doi: 10.21037/apm-20-1468. Epub 2020 Dec 24.
Endoscopic ultrasound (EUS)-guided radiofrequency ablation (RFA) is a novel modality in the treatment of solid tumours. The aim of the study is to evaluate the technical feasibility, safety and efficacy of multiple-round EUS-RFA with low ablation power for unresectable pancreatic cancer.
We conducted a retrospective analysis of eleven cases with unresectable pancreatic cancer who underwent EUS-RFA between November 2013 and November 2018. For each lesion, RITA 1500X radiofrequency generator was used to deliver 5-10 watts ablation power for 90 seconds, repeatedly. Eight cases underwent the same procedure one week later. Additionally, one patient with the lesion size of 29.7 mm underwent 8 total sessions of RFA every other week.
The procedure was successful in all cases and no major adverse events were observed. The post procedure imaging studies and serum CA19-9 level were performed 1 month after procedure, showing two patients had decreased lesion sizes and five patients had decreased serum CA19-9 level. Follow-up duration ranged 2 to 12 months. The patient who underwent 8 total sessions of RFA survived 12 months after followup and showed increased tumour apparent diffusion coefficient (ADC) value and 20% ablated area inside the tumour.
A multiple-round ablation with optimal RFA energy could be a technically feasible, safe and short-term efficacy option for those patients with unresectable pancreatic cancer.
内镜超声（EUS）引导下的射频消融（RFA）是治疗实体肿瘤的一种新方法。本研究的目的是评估低消融功率的多轮EUS-RFA治疗不可切除胰腺癌的技术可行性、安全性和有效性。
我们对2013年11月至2018年11月期间接受EUS-RFA治疗的11例不可切除胰腺癌患者进行了回顾性分析。对于每个病灶，使用RITA 1500X射频发生器，以5-10瓦的消融功率重复施加90秒。8例患者在一周后接受了相同的治疗。此外，一名病灶大小为29.7 mm的患者每隔一周共接受了8次RFA治疗。
所有病例手术均成功，未观察到重大不良事件。术后1个月进行了术后影像学检查和血清CA19-9水平检测，结果显示2例患者病灶大小减小，5例患者血清CA19-9水平降低。随访时间为2至12个月。接受8次RFA治疗的患者在随访12个月后存活，肿瘤表观扩散系数（ADC）值增加，肿瘤内部有20%的消融区域。
对于不可切除胰腺癌患者，采用最佳RFA能量进行多轮消融可能是一种技术可行、安全且具有短期疗效的选择。
