Ong Daniel Yuxuan, Pua Uei
Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore.
Diagnostics (Basel). 2023 Nov 16;13(22):3458. doi: 10.3390/diagnostics13223458.
Pancreatic cancer is a lethal disease, with locally advanced pancreatic cancer (LAPC) having a dismal prognosis. For patients with LAPC, gemcitabine-based regimens, with or without radiation, have long been the standard of care. Irreversible electroporation (IRE), a non-thermal ablative technique, may potentially prolong the survival of patients with LAPC. In this article, the authors present a case of LAPC of the uncinate process (biopsy proven pancreatic neuroendocrine carcinoma) with duodenal invasion. The patient had a combination of chemotherapy and radiation therapy but was found to have stable disease. He then underwent intra-operative IRE with cholecystectomy, Roux-en-Y gastrojejunostomy and hepaticojejunostomy. He subsequently underwent percutaneous IRE 13 months post open IRE. The patient also completed peptide receptor radionuclide therapy and has been started on Lanreotide. Following combination therapy, the pancreatic tumor showed significant reduction in size, with patient survival at 53 months post-diagnosis at the time of writing.
胰腺癌是一种致命疾病，局部晚期胰腺癌（LAPC）的预后很差。对于LAPC患者，含吉西他滨的治疗方案，无论是否联合放疗，长期以来一直是标准治疗方法。不可逆电穿孔（IRE）是一种非热消融技术，可能会延长LAPC患者的生存期。在本文中，作者介绍了一例钩突部LAPC（活检证实为胰腺神经内分泌癌）侵犯十二指肠的病例。该患者接受了化疗和放疗联合治疗，但疾病稳定。然后他接受了术中IRE，同时进行了胆囊切除术、Roux-en-Y胃空肠吻合术和肝空肠吻合术。他在开放IRE术后13个月接受了经皮IRE。该患者还完成了肽受体放射性核素治疗，并开始使用兰瑞肽。经过联合治疗后，胰腺肿瘤体积显著缩小，在撰写本文时，患者诊断后存活了53个月。
