Cryoablation in locally advanced pancreatic cancer: A promising ablative frontier

Table 1 Ablative modalities for locally advanced pancreatic cancer

Modality	Mechanism	Key advantage	Major limitation	Median overall survival (months)
Irreversible electroporation	Nonthermal apoptosis	Vessel-sparing; effective near major arteries	Requires cardiac synchronization; procedural risks	20-28
Cryoablation	Freeze-thaw necrosis and immune activation	Dual cytoreductive and immunogenic effects	Requires precise imaging guidance; limited trial data	16-20
Radiofrequency ablation	Thermal coagulation	Widely available	Heat-sink effect; duodenal injury risk	14-16
Microwave ablation	Dielectric heating	Larger ablation zones; faster ablation	Limited visibility; pancreatic fragility	15-17
Stereotactic body radiotherapy	Focused high-dose radiation	Non-invasive; high local control	Gastrointestinal toxicity	18-20
Intratumoral injection	Direct delivery (radioisotope, immune, chemotherapy agents)	Immunostimulatory potential	Heterogeneous techniques	7-16