Published online Jan 14, 2023. doi: 10.3748/wjg.v29.i2.223
Peer-review started: September 28, 2022
First decision: October 20, 2022
Revised: November 13, 2022
Accepted: December 21, 2022
Article in press: December 21, 2022
Published online: January 14, 2023
Processing time: 99 Days and 12.1 Hours
Pancreatic cancer is currently the seventh leading cause of cancer death (4.5% of all cancer deaths) while 80%-90% of the patients suffer from unresectable disease at the time of diagnosis. Prognosis remains poor, with a mean survival up to 15 mo following systemic chemotherapy. Loco-regional thermal ablative techniques are rarely implemented due to the increased risk of thermal injury to the adjacent structures, which can lead to severe adverse events. Irreversible electroporation, a promising novel non-thermal ablative modality, has been recently introduced in clinical practice for the management of inoperable pancreatic cancer as a safer and more effective loco-regional treatment option. Experimental and initial clinical data are optimistic. This review will focus on the basic principles of IRE tech
Core Tip: Loco-regional thermal ablative techniques such as radiofrequency, microwave, and cryoablation are rarely implemented for the treatment of inoperable pancreatic cancer due to the increased risk of thermal injury to the adjacent structures. Irreversible electroporation is a promising novel non-thermal ablative modality that could provide a safer and effective ablation via the application of electric pulses to damage cell membranes and cell homeostasis resulting in cancer cell necrosis and apoptosis. Experimental and initial clinical data are optimistic, and its potential immunomodulatory effect and synergism with immunotherapy provides are promising.