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[不可逆电穿孔:具有全身免疫效应的局部肿瘤消融]

[Irreversible electroporation: local tumor ablation with systemic immune effect].

作者信息

Geboers Bart, Timmer Florentine E F, van den Tol Petrousjka M, de Gruijl Tanja D, Scheffer Hester J, Meijerink Martijn R

机构信息

Amsterdam UMC, locatie VUmc, Cancer Center Amsterdam, Amsterdam: Afd. Radiologie en Nucleaire Geneeskunde.

Amsterdam UMC, locatie VUmc, Cancer Center Amsterdam, Amsterdam: Afd. Chirurgie.

出版信息

Ned Tijdschr Geneeskd. 2021 Sep 20;165:D5506.

PMID:34854585
Abstract

Irreversible electroporation (IRE) employs high-voltage electrical pulses for non-thermal image-guided tumor ablation in solid organs. The pulses disrupt the membrane potential of all cells within the ablation zone causing loss of tumour cell homeostasis resulting in death. IRE has the advantage of sparing extracellular matrix structures and thereby preserving the anatomical integrity of blood vessels, bile ducts, and ureters. This trait distinguishes IRE from more commonly used thermal ablation techniques like microwave- and radiofrequency ablation. Several prospective phase-1 and -2 studies demonstrated the safety and efficacy of IRE for the treatment of central liver, locally advanced pancreatic, and local prostate tumours. In addition, IRE induces a systemic immune response. When this immune effect can be amplified by combinatory treatment with immunotherapeutic drugs its synergy might form a bridge between local and systemic therapies with the potential to develop into a fundamentally new approach to cancer treatment.

摘要

不可逆电穿孔(IRE)采用高压电脉冲对实体器官进行非热图像引导的肿瘤消融。这些脉冲会破坏消融区内所有细胞的膜电位,导致肿瘤细胞内环境稳定丧失,从而造成细胞死亡。IRE的优势在于能够保留细胞外基质结构,进而维持血管、胆管和输尿管的解剖完整性。这一特性使IRE有别于更常用的热消融技术,如微波消融和射频消融。多项前瞻性1期和2期研究证明了IRE治疗肝中央区、局部晚期胰腺和局部前列腺肿瘤的安全性和有效性。此外,IRE还能引发全身免疫反应。当这种免疫效应可通过与免疫治疗药物联合治疗得到增强时,其协同作用可能会在局部治疗和全身治疗之间架起一座桥梁,有望发展成为一种全新的癌症治疗方法。

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