Advanced Ultrasound in Diagnosis and Therapy ›› 2018, Vol. 2 ›› Issue (2): 143-149.doi: 10.37015/AUDT.2018.180814

• Review Article • Previous Articles     Next Articles

Estimation of Clinical Outcomes of Irreversible Electroporation Use During Locally Advanced Pancreatic Cancer: A Systematic Review and Meta-analysis

Tian’an Jiang, PhDa,b, Guo Tian, MDa,b, Liming Wu, PhDc,d,*(), Qiyu Zhao, PhDa,*()   

  1. a Department of Ultrasound Medicine, the First Afliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
    b Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou, China
    c Department of Hepatobiliary and Pancreatic Surgery, the First Afliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
    d Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
  • Received:2018-06-27 Online:2018-08-18 Published:2018-08-19
  • Contact: Liming Wu, PhD,Qiyu Zhao, PhD, E-mail:derman2000@zju.edu.cn;wlm@zju.edu.cn

Abstract:

Objective: Irreversible electroporation (IRE) is a novel nonthermal ablative technique that transmits pulsatile electricity to enable nanoscale damages of the cellular membrane and induce cellular apoptosis. To assess the safety and efficacy of IRE for locally advanced pancreatic cancer (LAPC).
Methods: Electronic databases of PubMed, Embase, Web of Science, Scopus were searched up to June 2018 for studies comparing the standardized mean differences (SMD) of size, amylase and carbohydrate antigen 19-9 (CA199) levels between pre- and post-operation for patients with pancreatic cancer. Sensitivity and stratified analyses were conducted. Quality was estimated using Newcastle-Ottawa Scale (NOS).
Results: We finally identified 10 studies including 203 participants during a mean 7.06 months of follow-up (range 1 to 29 months). The meta-analyses showed the declined tumor size at 6 months post-IRE but unchanged at 1 month, and increased amylase level at 1-day post-IRE while unchanged at the 1 week. No significant difference of CA199 level was observed between pre-IRE and post-IRE at 1 week and 1 month. No risk of publication bias was detectable, and the favorable quality and validity of all outcomes were assessed based on NOS.
Conclusions: IRE may be a relatively state-of-the-art therapy option for most patients with LAPC if imaging or explorative laparotomy indicated that LAPC was unable to be successfully resected.

Key words: Irreversible electroporation; Pancreatic cancer; Meta; Systematic review; Outcome