Review
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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2021; 27(27): 4322-4341
Published online Jul 21, 2021. doi: 10.3748/wjg.v27.i27.4322
Table 1 Studies evaluating intraoperative pancreas radiofrequency ablation
Ref. Study type Patients Outcome measure Results Complica-tions Giardino et al [16 ], 2013 Retrospective 107 OS RFA 1st line: 14.7 mo RFA + adjuvant: 25.6 mo Mortality: 1.8%; morbidity: 28% Girelli et al [18 ], 2013 Prospective 100 OS and DSS 20 and 23 mo Mortality 3%; morbidity 24% Girelli et al [14 ], 2010 Prospective 50 Safety and feasibility - Mortality 2%; morbidity 24% Spiliotis et al [15 ], 2007 Retrospective 25 OS OS: 33 mo1 Mortality: 0%; morbidity: 23% Wu et al [13 ], 2006 Prospective 16 Pain relief 50% pain relief 90-d mortality: 25%; Matsui et al [12 ], 2000 Prospective 29 OS OS: 3 mo Mortality: 10%
Table 2 Studies evaluating microwave ablation of pancreatic cancer
Ref. Patients Survival Procedure Guidance Major adverse events Lygidakis et al [23 ], 2007 15 Up to 22 mo Open N/A No Carrafiello et al [21 ], 2013 10 80% at 1 yr 5 open, 5 percutaneous US, US/CT 2 Vogl et al [24 ], 2018 20 N/A Percutaneous CT No Ierardi et al [22 ], 2018 5 N/A Percutaneous US No
Table 3 Studies evaluating intraoperative irreversible electroporation of pancreatic cancer
Author Patients Median OS(mo) Guidancemodality Major adverse events Paiella et al [53 ], 2015 10 7.5 US 20% Martin et al [48 ], 2015 200 24.9 US 22% Kluger et al [52 ], 2015 50 7.7 Not reported 38% Lambert et al [54 ], 2015 21 10.2 Not reported 24% Yan et al [57 ], 2016 25 Not reported US 16% Vogel et al [50 ], 2017 15 16 US 53% Huang et al [47 ], 2018 70 22.6 US 4% Yang et al [105 ], 2020 74 53% (3 yr)1 US 12% He et al [106 ], 2020 36 53.5% (2 yr)2 US 5% He et al [49 ], 2020 167 16 US N/A
Table 4 Studies evaluating percutaneous IRE in pancreatic cancer
Ref. Patients Median OS from IRE Guidance Major adverse events Belfiore et al [64 ], 2015 20 13.951 mo CT 0% Narayanan et al [61 ], 2017 50 14.2 mo CT 20% Zhang et al [58 ], 2017 21 N/A CT/US 0% Scheffer et al [65 ], 2017 25 11 mo CT 40% Månsson et al [59 ], 2019 24 13.3 mo US 25% Flak et al [60 ], 2019 33 10.7 mo US 20% Ruarus et al [62 ], 2020 50 10 mo CT 42% Ma et al [51 ], 2020 33 19.8 mo CT 9%
Table 5 Active pancreas irreversible electroporation clinical trials (source: ClinicalTrials.gov)
Title Location Hyperlink Patients Estimated completion An open-label, multicenter, prospective study of IRE (Nano Knife) combined with radiotherapy and chemotherapy in patients with LAPC Shanghai, China https://clinicaltrials.gov/ct2/show/NCT04310553 40 December, 2020 Ablation of unresectable LAPC with IRE system Teaneck, New Jersey, United States https://clinicaltrials.gov/ct2/show/NCT03614910 30 May, 2023 Chemotherapy followed by irreversible electroporation in patients with unresectable LAPC Aalborg, Denmark https://clinicaltrials.gov/ct2/show/NCT04093141 30 May, 2024 Chemotherapy and IRE in the treatment of advanced pancreatic adenocarcinoma Louisville, Kentucky, United States https://clinicaltrials.gov/ct2/show/NCT03484299 20 December, 2023 PANFIRE-3 trial: Assessing safety and efficacy of IRE + Nivolumab + CpG for metastatic pancreatic cancer Amsterdam, North-Holland, Netherlands https://clinicaltrials.gov/ct2/show/NCT04612530 18 October, 2022 Outcomes of ablation of unresectable pancreatic cancer using the nanoknife IRE system Baltimore, Maryland, United States https://clinicaltrials.gov/ct2/show/NCT02041936 12 December, 2021 Immunotherapy and IRE in the treatment of advanced pancreatic adenocarcinoma Louisville, Kentucky, United States https://clinicaltrials.gov/ct2/show/NCT03080974 10 April, 2022 A study of the use of IRE in pancreatic ductal cancer Toronto, Ontario, Canada https://clinicaltrials.gov/ct2/show/NCT03257150 47 September, 2021 Safety and efficacy of IRE for LAPC Seoul, Korea, Republic of https://clinicaltrials.gov/ct2/show/NCT02898649 100 August, 2019 IRE (Nano Knife) for the treatment of pancreatic adenocarcinoma Poitiers, France https://clinicaltrials.gov/ct2/show/NCT03105921 20 June, 2020 IRE for inoperable hepatic and pancreatic malignancy Hong Kong https://clinicaltrials.gov/ct2/show/NCT02822716 35 December, 2021 Phase II/III of randomized controlled clinical research on IRE synchronous chemotherapy for LAPC Guangzhou, Guangdong, China https://clinicaltrials.gov/ct2/show/NCT03673137 120 November, 2021 Anti-tumor immunity induced by IRE of unresectable pancreatic cancer Guangzhou, Guangdong, China https://clinicaltrials.gov/ct2/show/NCT02343835 20 January, 2025 A pivotal study of safety and effectiveness of Nano Knife IRE for stage 3 pancreatic cancer USA, Multicentre https://clinicaltrials.gov/ct2/show/NCT03899636 528 December, 2023 Immunologic signatures following surgery for pancreatic cancer Durham, North Carolina, United States https://clinicaltrials.gov/ct2/show/NCT03001518 30 April, 2027
Table 6 Studies evaluating percutaneous liver ablation in metastatic pancreatic cancer
Ref. Modality Patients Median OS from ablation Guidance Major adverse events Park et al [77 ], 2012 RFA 34 14 mo US Not reported Hua et al [78 ], 2017 RFA 102 11.4 mo US 9.8% Lee et al [79 ], 2020 RFA 94 12 mo US (n = 91), CT (n = 3) 8.5% Bailey et al [80 ], 2019 Mixed 20 9.7 mo Mixed N/A
Table 7 Transarterial chemoembolization in liver-metastatic pancreatic cancer
Ref. Patients Median OS from TACE Technique Vogl et al [82 ], 2015 112 19.2 mo cTACE after mitomycin C, cisplatin, and gemcitabine chemoperfusion Azizi et al [83 ], 2011 32 16 mo cTACE after mitomycin C, cisplatin, and gemcitabine chemoperfusion Sun et al [84 ], 2017 27 23 mo Chemoperfusion with gemcitabine, oxaplatin, and irinotecan plus embolization with Lipiodol + pirarubicin or DEB with pirarubicin
Table 8 Transarterial radioembolization in liver-metastatic pancreatic cancer
Ref. Patients Median OS from TARE Technique Michl et al [96 ], 2014 19 9 mo Resin microspheres Kim et al [97 ], 20161 16 12.5 mo Resin microspheres Kim et al [99 ], 20171 24 6 mo Resin microspheres Kim et al [98 ], 20191 33 8.1 mo Resin microspheres Kayaleh et al [100 ], 2020 26 7 mo Glass microspheres