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首页> 外文期刊>Techniques in vascular and interventional radiology >Irreversible Electroporation for Locally Advanced Pancreatic Cancer
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Irreversible Electroporation for Locally Advanced Pancreatic Cancer

机译：局部晚期胰腺癌的不可逆电穿孔

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摘要

Several minimally invasive image guided tumor ablation techniques have been added to the treatment spectrum for locally advanced pancreatic cancer (LAPC). Irreversible electropo- ration (IRE) might have a significant additive value in the management of this difficult - to -treat disease. As opposed to thermal ablative techniques, IRE induces cell death by the delivery of high - voltage electrical pulses. The electrical energy disrupts the cellular membrane integrity, causes loss of cellular homeostasis and ultimately results in cell death. The extracellular matrix of connective tissue in surrounding delicate structures such as bile ducts, bowel wall, and larger blood vessels is spared. The preservation of these structures makes IRE attractive for the treatment of pancreatic cancers that are unresectable due to their anatomical location (ie, LAPC and local recurrence after surgical resection). In addition to its cytoreductive abili- ties, evidence is emerging on IRE?s capability to induce systemic immunomodulation through active in vivo vaccination against pancreatic cancer cells. These effects in combination with immunotherapy may offer a new treatment paradigm for tumors with low immunogenic poten- tial like pancreatic ductal adenocarcinoma (PDAC). This review discusses several practical and technical issues of IRE for LAPC: clinical evaluation, indications, patient preparations, procedural steps, imaging characteristics, clinical results, and ?tricks of the trade? used to improve the safety and efficacy of the treatment. Future directions such as the combination of IRE with immunotherapy will be shortly addressed. Tech Vasc Interventional Rad 23:100675 (c) 2020 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license. (http://creativecommons.org/licenses/by/4.0/)
机译：局部晚期胰腺癌（LAPC）的治疗谱中增加了几种微创图像引导肿瘤消融技术。不可逆电刺激（IRE）在治疗这种难治性疾病时可能具有显著的附加值。与热烧蚀技术相反，IRE通过传递高压电脉冲诱导细胞死亡。电能破坏细胞膜的完整性，导致细胞内稳态的丧失，最终导致细胞死亡。周围脆弱结构（如胆管、肠壁和较大血管）中结缔组织的细胞外基质得以保留。这些结构的保存使得IRE对于因其解剖位置（即LAPC和手术切除后局部复发）而无法切除的胰腺癌的治疗具有吸引力。除了细胞还原能力，IRE上也出现了证据？通过体内主动接种胰腺癌细胞诱导系统免疫调节的能力。这些效应与免疫治疗相结合，可能为免疫原性低的肿瘤如胰腺导管腺癌（PDAC）提供一种新的治疗模式。本综述讨论了LAPC中IRE的几个实际和技术问题：临床评估、适应症、患者准备、程序步骤、成像特征、临床结果，以及？行业的诀窍？用于提高治疗的安全性和有效性。诸如IRE与免疫治疗相结合的未来方向将很快得到解决。Tech Vasc介入Rad 23:100675（c）2020作者。由爱思唯尔公司出版。这是一篇基于CC by license的开放获取文章。(http://creativecommons.org/licenses/by/4.0/)

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