Adeyeye Ademola, Olabintan Olaolu, Ayubi Homira, Gao Hao, Saini Aman, Emmanuel Andrew, Hayee Bu'Hussain, Haji Amyn
King's College Hospital, Denmark Hill, London SE5 9RS, UK.
J Clin Med. 2025 Jun 11;14(12):4138. doi: 10.3390/jcm14124138.
Colorectal cancer (CRC) is the most common gastrointestinal (GI) malignancy, the second leading cause of cancer-related mortality, and the third most prevalent tumor. Around 20% of cases are metastatic or inoperable at diagnosis, often requiring palliative treatment, which may not be feasible in frail patients. Calcium-electroporation, a less invasive alternative, induces cell death via apoptosis, necrosis, and pyroptosis. This study is the first in the United Kingdom to evaluate the efficacy and safety of endoscopic calcium-electroporation in palliating distal CRC. : Frail patients with inoperable left-sided CRC were included. The diagnosis and staging followed standard guidelines, while frailty was assessed using the performance status (PFS), Charlson comorbidity index (CCI), and American Society of Anesthesiologists (ASA) score. Calcium electroporation was performed via a flexible endoscopy usually under sedation, with symptom relief, quality of life (QoL), survival, and adverse events (AE) monitored. Sixteen patients (median age 84.5) underwent 36 treatments with electroporation over 28 months (November 2022 to March 2025). The incidence of common symptoms was rectal bleeding (75%), constipation (25%), and pain (75%). Nine patients had metastases and three had failed conventional treatments. Symptomatic relief and an improved QoL occurred in 86.7%, with transfusion/iron infusion needs reduced by 91.7%. The median cancer-specific survival was 10 months, with a 94% survival rate. No device-related AE was recorded. One patient died after 11 months due to disease progression while two patients passed away from other medical conditions. : Endoscopic calcium electroporation is a safe, palliative option effective for tumor reduction and symptomatic relief in frail CRC patients unfit for conventional therapies.
结直肠癌（CRC）是最常见的胃肠道（GI）恶性肿瘤，是癌症相关死亡的第二大原因，也是第三大常见肿瘤。约20%的病例在诊断时已发生转移或无法手术，通常需要姑息治疗，而这在体弱患者中可能并不可行。钙电穿孔是一种侵入性较小的替代方法，可通过凋亡、坏死和焦亡诱导细胞死亡。本研究是英国首次评估内镜下钙电穿孔缓解远端CRC的疗效和安全性。纳入了无法手术的左侧CRC体弱患者。诊断和分期遵循标准指南，同时使用体能状态（PFS）、查尔森合并症指数（CCI）和美国麻醉医师协会（ASA）评分评估体弱程度。钙电穿孔通常在镇静下通过柔性内镜进行，监测症状缓解情况、生活质量（QoL）、生存率和不良事件（AE）。16名患者（中位年龄84.5岁）在28个月（2022年11月至2025年3月）内接受了36次电穿孔治疗。常见症状的发生率为直肠出血（75%）、便秘（25%）和疼痛（75%）。9名患者有转移，3名患者传统治疗失败。86.7%的患者症状得到缓解，生活质量得到改善，输血/铁剂输注需求减少了91.7%。癌症特异性生存期中位值为10个月，生存率为94%。未记录到与设备相关的不良事件。1名患者在11个月后因疾病进展死亡，2名患者因其他医疗状况去世。内镜下钙电穿孔是一种安全的姑息治疗选择，对不适于传统治疗的体弱CRC患者有效缩小肿瘤并缓解症状。
