Clinical efficacy and feasibility analysis of irreversible electroporation combined with chemotherapy for stage Ⅳ pancreatic cancer treatment

doi:10.3877/cma.j.issn.2095-5782.2025.03.004

Abstract

Abstract:

Objective

To evaluate the clinical efficacy and feasibility of irreversible electroporation (IRE) combined with chemotherapy in patients with stage Ⅳ pancreatic cancer.

Methods

A retrospective analysis was conducted on 42 patients with stage Ⅳ pancreatic cancer treated at the General Hospital of Tianjin Medical University between September 2021 and March 2024. Twenty-two patients received IRE in combination with chemotherapy, and 20 received chemotherapy alone. Data collected included tumor location, tumor size, and pre- and postoperative chemotherapy regimens. Patients were followed regularly to document IRE-related adverse events and assess overall survival (OS).

Results

The median OS was longer in the IRE group than in the chemotherapy group (P=0.283). Median progression-free survival (PFS) was also slightly longer in the IRE group (P=0.167). The mean length of hospital stay for the IRE group was 5.9±0.75 days. Serious IRE-related adverse events occurred in five patients: pyloric edema (n=1), obstructive jaundice (n=1), pancreatitis (n=2), and intraoperative bleeding (n=1). Postoperative pain scores were significantly reduced compared with preoperative scores (P<0.05).

Conclusion

IRE combined with chemotherapy may be a feasible and clinically beneficial option for stage Ⅳ pancreatic cancer, offering modest survival benefits, reduction in local pain symptoms, fewer adverse effects, and shorter hospitalization time.

Key words: irreversible electroporation, advanced pancreatic cancer, nano knife, Interventional therapy for pancreatic cancer

Xu LANG, Jia ZENG. Clinical efficacy and feasibility analysis of irreversible electroporation combined with chemotherapy for stage Ⅳ pancreatic cancer treatment[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2025, 13(03): 217-221.

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Figures/Tables 5

组别	例数	年龄（岁， $x ¯ ± s$ ）	性别 [例(%)]		最大直径（cm， $x ¯ ± s$ ）	CA-199 (U/mL， $x ¯ ± s$ )	肿瘤位置 [例(%)]		化疗方案 [例(%)]
组别	例数	年龄（岁， $x ¯ ± s$ ）	男性	女性	最大直径（cm， $x ¯ ± s$ ）	CA-199 (U/mL， $x ¯ ± s$ )	胰头	胰体/尾	FOLFIRINOX	AG	其他
IRE组	22	67.67±2.05	12（54.50）	10（45.40）	4.23±0.31	14.57±6.04	15（68.20）	7（31.80）	8（36.40）	10（45.40）	4（18.20）
化疗组	20	65.86±1.55	10（50.00）	10（50.00）	3.77±0.26	17.75±7.83	13（65.00）	7（35.00）	6（30.00）	10（50.00）	4（20.00）
检验值		0.89	0.09		1.22	0.92	0.05		0.19
P值		0.49	0.77		0.26	0.36	0.83		0.84

组别	例数	年龄（岁， $x ¯ ± s$ ）	性别 [例(%)]		最大直径（cm， $x ¯ ± s$ ）	CA-199 (U/mL， $x ¯ ± s$ )	肿瘤位置 [例(%)]		化疗方案 [例(%)]
组别	例数	年龄（岁， $x ¯ ± s$ ）	男性	女性	最大直径（cm， $x ¯ ± s$ ）	CA-199 (U/mL， $x ¯ ± s$ )	胰头	胰体/尾	FOLFIRINOX	AG	其他
IRE组	22	67.67±2.05	12（54.50）	10（45.40）	4.23±0.31	14.57±6.04	15（68.20）	7（31.80）	8（36.40）	10（45.40）	4（18.20）
化疗组	20	65.86±1.55	10（50.00）	10（50.00）	3.77±0.26	17.75±7.83	13（65.00）	7（35.00）	6（30.00）	10（50.00）	4（20.00）
检验值		0.89	0.09		1.22	0.92	0.05		0.19
P值		0.49	0.77		0.26	0.36	0.83		0.84

不良反应	数据[例(%)]	处理方法
疼痛	13（59.10）	口服、静滴止疼药
乏力	11（50.00）	未处理
恶心呕吐	7（31.82）	止吐药
高血压	4（18.18）	降压药
腹胀	5（22.73）	未处理
感染	10（45.45）	抗生素
胰腺炎	2（9.09）	抗生素
出血	1（4.55）	止血药
幽门水肿	1（4.55）	未处理
梗阻性黄疸	1（4.55）	降胆红素，必要时引流

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