Rompianesi Gianluca, Loiaco Giuseppe, Rescigno Luigi, Benassai Gianluca, Giglio Mariano Cesare, Campanile Silvia, Caggiano Marcello, Montalti Roberto, Troisi Roberto Ivan
Department of Clinical Medicine and Surgery, Division of Minimally Invasive and Robotic HPB S and Gery, Transplantation Service, Federico II University Hospital, Via Sergio Pansini 5, 80131 Naples, Italy.
Department of Public Health, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy.
Cancers (Basel). 2025 Jan 26;17(3):408. doi: 10.3390/cancers17030408.
Pancreatic ductal adenocarcinoma (PDAC) is one of the most difficult cancers to treat, with a dismal 5-year survival rate of only 8-10%. This challenging prognosis highlights the urgent need for innovative therapeutic approaches to improve outcomes for patients with PDAC. Electrochemotherapy (ECT), which enhances intracellular chemotherapeutic uptake via electric pulses, has been explored for resectable, borderline resectable (BR), locally advanced (LA), recurrent, and metastatic PDAC, either as a complement to conventional treatments or as an alternative when these are not feasible or effective, offering possible benefits in symptomatic palliation and local tumor control.
A systematic review was performed in accordance with PRISMA guidelines for studies assessing the efficacy of ECT in PDAC. After searching Embase, PubMed/MEDLINE, Scopus, and Web of Science, five studies with a combined total of 43 patients in various disease stages were identified.
ECT showed promise in improving tumor control, alleviating cancer-related pain, and improving quality of life. One study noted a trend towards tumor size reduction of 8.3% at one-month and 16.1% at six-months follow-up ( = 0.211 and = 0.315), although these findings were derived from studies conducted without specific comparative control groups. Severity of complication was mainly mild (Clavien-Dindo I-II), while severe complications occurred in only 2.3% of patients. Median overall survival was reported in two studies as 8 months (range 2-19) and 11.5 months (range 1-74). ECT showed efficacy for symptom management, with 60% of patients reporting reduced pain/discomfort and 40% showing enhanced quality of life in one study, while another reported pain scores as decreasing from 6 to 3 at one month and to 2 at six months.
ECT appears to be a new promising and safe adjunct treatment modality in PDAC management across different disease stages, with potential benefits in tumor control, cancer-related pain reduction, and quality of life. Further studies are warranted to validate these findings and identify patients who could benefit most.
胰腺导管腺癌（PDAC）是最难治疗的癌症之一，其5年生存率低至仅8-10%，令人沮丧。这种具有挑战性的预后凸显了迫切需要创新治疗方法来改善PDAC患者的治疗效果。电化学疗法（ECT）通过电脉冲增强细胞内化疗药物摄取，已被用于可切除、边缘可切除（BR）、局部晚期（LA）、复发和转移性PDAC，作为传统治疗的补充，或在传统治疗不可行或无效时作为替代方法，在缓解症状和局部肿瘤控制方面可能具有益处。
根据PRISMA指南进行系统评价，以评估ECT在PDAC中的疗效。在检索Embase、PubMed/MEDLINE、Scopus和Web of Science后，确定了五项研究，共纳入43例处于不同疾病阶段的患者。
ECT在改善肿瘤控制、减轻癌症相关疼痛和提高生活质量方面显示出前景。一项研究指出，在随访1个月时肿瘤大小有缩小8.3%的趋势，6个月时缩小16.1%（P = 0.211和P = 0.315），尽管这些结果来自没有特定对照比较组的研究。并发症严重程度主要为轻度（Clavien-Dindo I-II级），严重并发症仅发生在2.3%的患者中。两项研究报告的中位总生存期分别为8个月（范围2-19个月）和11.5个月（范围1-74个月）。ECT在症状管理方面显示出疗效，一项研究中60%的患者报告疼痛/不适减轻，40%的患者生活质量提高，而另一项研究报告疼痛评分在1个月时从6分降至3分，6个月时降至2分。
ECT似乎是一种在不同疾病阶段的PDAC治疗中具有前景且安全的新辅助治疗方式，在肿瘤控制、减轻癌症相关疼痛和提高生活质量方面具有潜在益处。有必要进行进一步研究以验证这些发现，并确定最能从中受益的患者。
