Abstract
Background and Objective: Pancreatic cancer continues to be associated with high mortality rates and low 5-year survival rates. The inability to detect pancreatic cancer in a timely manner and the aggressiveness associated with the disease progression are two of the many factors that contribute to its elevated mortality rate. Patients that do not qualify for surgery can be treated with needle-guided ablation techniques such as radiofrequency ablation (RFA), cryoablation, microwave ablation (MWA) or irreversible electroporation (IRE).
Methods: Authors of the narrative review utilized search engines such as PubMed and Google Scholar as sources with keywords such as, “pancreatic cancer, radiofrequency ablation, irreversible electroporation, microwave ablation, cryoablation, chemotherapy, FOLFIRINOX, PELICAN, or PANFIRE”.
Key Content and Findings: Pancreatic cancer can be treated through chemotherapy, surgery, cryoablation, MWA, RFA or IRE. Data on treatment of pancreatic adenocarcinoma with MWA shows varying oncologic outcomes, while the data presented on treatment with cryoablation, overall, shows a lack of serious side effects and could potentially serve as an effective palliative treatment. The limited amount of data shows that RFA could also potentially be a safe and effective approach for treating locally advanced pancreatic cancer (LAPC). The recently initiated PELICAN (Pancreatic Locally Advanced Unresectable Cancer Ablation) trial, a randomized controlled trial (RTC) that compares the overall survival (OS) of patients with LAPC that were treated with both RFA and chemotherapy versus chemotherapy alone, could produce more useful data on the treatment of LAPC with RFA. Published retrospective studies, such as the PANFIRE I and II trials, have both investigated the use of IRE in the treatment of LAPC, and have shown that IRE could serve as a key factor in increased OS rates in LAPC patients.
Conclusions: Although data is limited on current ablative modalities in the treatment of pancreatic cancer, IRE has demonstrated its safety and effectiveness in the treatment of LAPC, affording patients a longer 2-year OS in comparison to RFA after induction chemotherapy. Overall, data from all ongoing prospective trials could offer new insight in the effectiveness and safety of each ablation method in the treatment of pancreatic cancer.
Publication Date
6-30-2024
Content Type
Article
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Citation
Narayanan, G., Jivani, G. G., Mahendra, A. M., & Gentile, N. (2024). A narrative review of interventional oncology approaches to treating pancreatic cancer. Digestive Medicine Research, 7. https://dmr.amegroups.org/article/view/9555
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