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射频消融在不可切除胰腺癌治疗中的作用

Role of Radiofrequency Ablation in the Management of Unresectable Pancreatic Cancer.

作者信息

Yousaf Muhammad Nadeem, Ehsan Hamid, Muneeb Ahmad, Wahab Ahsan, Sana Muhammad K, Neupane Karun, Chaudhary Fizah S

机构信息

Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, United States.

MedStar Franklin Square Medical Center, Baltimore, MD, United States.

出版信息

Front Med (Lausanne). 2021 Feb 11;7:624997. doi: 10.3389/fmed.2020.624997. eCollection 2020.

Abstract

Pancreatic cancer is one of the most aggressive malignancies of the digestive tract and carries a poor prognosis. The majority of patients have advanced disease at the time of diagnosis. Surgical resection offers the only curative treatment, but only a small proportion of patients can undergo surgical resection. Radiofrequency ablation (RFA) is a well-known modality in the management of solid organ tumors, however, its utility in the management of pancreatic cancer is under investigation. Since the past decade, there is increasing use of RFA as it provides a feasible palliation treatment in the management of unresectable pancreatic cancer. RFA causes tumor cytoreduction through multiple mechanisms such as coagulative necrosis, protein denaturation, and activation of anticancer immunity. The safety profile of RFA is controversial because of the high risk for complications, however, small prospective and retrospective studies have shown promising results in its applicability for palliative management of unresectable pancreatic malignancies. In this review, we discuss different approaches of RFA, their indications, technical accessibility, safety, and major complications in the management of unresectable pancreatic cancer.

摘要

胰腺癌是消化道最具侵袭性的恶性肿瘤之一,预后较差。大多数患者在确诊时已处于疾病晚期。手术切除是唯一的治愈性治疗方法,但只有一小部分患者能够接受手术切除。射频消融(RFA)是实体器官肿瘤治疗中一种广为人知的方式,然而,其在胰腺癌治疗中的效用仍在研究中。自过去十年以来,RFA的使用越来越多,因为它在不可切除胰腺癌的治疗中提供了一种可行的姑息治疗方法。RFA通过多种机制导致肿瘤细胞减少,如凝固性坏死、蛋白质变性和抗癌免疫激活。由于并发症风险高,RFA的安全性存在争议,然而,小型前瞻性和回顾性研究表明,其在不可切除胰腺恶性肿瘤的姑息治疗中的适用性有令人鼓舞的结果。在本综述中,我们讨论了RFA在不可切除胰腺癌治疗中的不同方法、其适应症、技术可及性、安全性和主要并发症。

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