Govindarajan Narayanan1, Peter J Hosein2, Isabelle C Beulaygue3, Tatiana Froud3, Hester J Scheffer4, Shree R Venkat3, Ana M Echenique3, Elizabeth C Hevert5, Alan S Livingstone6, Caio M Rocha-Lima7, Jaime R Merchan8, Joseph U Levi6, Jose M Yrizarry3, Riccardo Lencioni3. 1. Department of Interventional Radiology, University of Miami Miller School of Medicine, 1475 NW 12th Avenue, C-080, Miami, FL 33136. Electronic address: gnarayanan@med.miami.edu. 2. Division of Medical Oncology, Department of Medicine, University of Kentucky, Lexington, Kentucky. 3. Department of Interventional Radiology, University of Miami Miller School of Medicine, 1475 NW 12th Avenue, C-080, Miami, FL 33136. 4. Department of Radiology and Nuclear Medicine, VU University Medical Center Amsterdam, Amsterdam, The Netherlands. 5. Department of Radiology, Jackson Memorial Hospital, Miami, Florida. 6. Department of Medicine, Sylvester Comprehensive Cancer Center, and Department of Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Avenue, C-080, Miami, FL 33136. 7. Division of Oncology, Gibbs Cancer Center & Research Institute, Spartanburg, South Carolina. 8. Division of Medical Oncology, University of Miami Miller School of Medicine, 1475 NW 12th Avenue, C-080, Miami, FL 33136.
Abstract
PURPOSE: To describe safety and effectiveness of percutaneous irreversible electroporation (IRE) for treatment of unresectable, locally advanced pancreatic adenocarcinoma (LAPC). MATERIALS AND METHODS: This retrospective study included 50 patients (23 women, 27 men; age range, 46-91 y; median age, 62.5 y) with biopsy-proven, unresectable LAPC who received percutaneous computed tomography (CT)-guided IRE. The primary objective was to assess the safety profile of the procedure; the secondary objective was to determine overall survival (OS). All patients had prior chemotherapy (1-5 lines, median 2), and 30 (60%) of 50 patients had prior radiation therapy. Follow-up included CT at 1 month and at 3-month intervals thereafter. RESULTS: There were no treatment-related deaths and no 30-day mortality. Serious adverse events occurred in 10 (20%) of 50 patients (abdominal pain [n = 7], pancreatitis [n = 1], sepsis [n = 1], gastric leak [n = 1]). Median OS was 27.0 months (95% confidence interval [CI], 22.7-32.5 months) from time of diagnosis and 14.2 months (95% CI, 9.7-16.2 months) from time of IRE. Patients with tumors ≤ 3 cm (n = 24) had significantly longer median OS than patients with tumors > 3 cm (n = 26): 33.8 vs 22.7 months from time of diagnosis (P = .002) and 16.2 vs 9.9 months from time of IRE (P = .031). Tumor size was confirmed as the only independent predictor of OS at multivariate analysis. CONCLUSIONS: Percutaneous image-guided IRE of unresectable LAPC is associated with an acceptable safety profile. Published by Elsevier Inc.
PURPOSE: To describe safety and effectiveness of percutaneous irreversible electroporation (IRE) for treatment of unresectable, locally advanced pancreatic adenocarcinoma (LAPC). MATERIALS AND METHODS: This retrospective study included 50 patients (23 women, 27 men; age range, 46-91 y; median age, 62.5 y) with biopsy-proven, unresectable LAPC who received percutaneous computed tomography (CT)-guided IRE. The primary objective was to assess the safety profile of the procedure; the secondary objective was to determine overall survival (OS). All patients had prior chemotherapy (1-5 lines, median 2), and 30 (60%) of 50 patients had prior radiation therapy. Follow-up included CT at 1 month and at 3-month intervals thereafter. RESULTS: There were no treatment-related deaths and no 30-day mortality. Serious adverse events occurred in 10 (20%) of 50 patients (abdominal pain [n = 7], pancreatitis [n = 1], sepsis [n = 1], gastric leak [n = 1]). Median OS was 27.0 months (95% confidence interval [CI], 22.7-32.5 months) from time of diagnosis and 14.2 months (95% CI, 9.7-16.2 months) from time of IRE. Patients with tumors ≤ 3 cm (n = 24) had significantly longer median OS than patients with tumors > 3 cm (n = 26): 33.8 vs 22.7 months from time of diagnosis (P = .002) and 16.2 vs 9.9 months from time of IRE (P = .031). Tumor size was confirmed as the only independent predictor of OS at multivariate analysis. CONCLUSIONS: Percutaneous image-guided IRE of unresectable LAPC is associated with an acceptable safety profile. Published by Elsevier Inc.
Authors: Jayanth S Shankara Narayanan; Partha Ray; Tomoko Hayashi; Thomas C Whisenant; Diego Vicente; Dennis A Carson; Aaron M Miller; Stephen P Schoenberger; Rebekah R White Journal: Cancer Immunol Res Date: 2019-08-13 Impact factor: 11.151
Authors: G Z Wang; X H He; Y Wang; L C Xu; H Z Huang; Y H Wang; Z Shen; X D Qu; X Y Ding; J J Yang; W T Li Journal: Curr Oncol Date: 2019-10-01 Impact factor: 3.677
Authors: Elizabeth Anne C Hevert; Collin G Howser; Michael L Gould; Daniel B Brown Journal: Semin Intervent Radiol Date: 2019-08-19 Impact factor: 1.513