Benefitial role of electrochemotherapy in locally advanced pancreatic cancer – radiological perspective

Abstract

Irreversible electroporation (IRE) of locally advanced pancreatic cancer is an increasingly used method for unresect able pancreatic cancer that can be used in cytoreduction followed by surgical treatment and shows promising results in palliative care.IRE is an ablative technique where electric pulses cause damage to the cell membrane leading to apoptosis without the destruction of stroma. The application of IRE increases the concentration of hydrophobic regimens like bleomy cin within the tumor, what could improve the effectiveness of treatment. This fusion of those two treatments is called electrochemotherapy. In this review, the authors will discuss the radiological perspective of possible beneficial role of irreversible electroporation in relation with chemotherapy in pancreatic cancer treatment.

Comments on “The beneficial role of electrochemotherapy in locally advanced pancreatic cancer - radiological perspective”

“…a combined low-dose of chemotherapeutic drugs with an electrical field that determines a transient increase of cell permeability (reversible electroporation), allowing uptake of chemotherapeutic drugs into the tumour, using low doses and reducing the cytotoxic effects [ 4 , 5 ]. Therefore, in contrast to what was reported Dr Kozak and colleagues [ 1 ], IRE cannot be defined with the term of ECT, and, although both IRE and ECT can be safely used to treat LAPC patients, these techniques are profoundly different [ 6 - 10 ]. Some authors have evaluated the feasibility and effectiveness of electrochemotherapy on deep tumours [ 6 - 18 ].…”

“…We read with interest the article from Dr. Kozak and colleagues in "Polish Journal of Radiology" [1], in which they assessed irreversible electroporation (IRE) as an interesting tool in the treatment of locally advanced pancreatic cancer (LAPC). We congratulate the authors on their accuracy in data presentation about IRE in LAPC reporting recently published manuscripts [2][3][4].…”

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“…Furthermore, the rates of overall survival (OS) and progression free survival (PFS) were greater for patients who received an induction of chemotherapy followed by IRE treatment than for those who underwent chemotherapy treatment alone [ 90 ]. Furthermore, it is increasingly gaining traction the concept of electrochemotherapy, which combines the use of IRE and hydrophobic regimens like bleomycin, able to increase the concentration of the latter within the tumor and enhance the effectiveness of treatment [ 91 ]. In their study, Rudno-Rudzińska et al discovered compelling results in terms of overall survival in patients who underwent IRE + CHT [ 92 ].…”