Clinical Efficacy of Ultrasound-Guided Irreversible Electroporation in Treatment of Advanced Hepatic Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LAILong-xiang ¹ , SUJuan ² , LUHao ¹ , CHENJun-zhou ¹ ,  ZHOUNing-xin. ¹

1. 1.Department of Hepatobiliary, The Rockets Army General Hospital of PLA, Beijing 100088, China;
2. 2.Department of Vascular Neurosurgery, The Rockets Army General Hospital of PLA, Beijing 100088, China;

Corresponding author：

ZHOUNing-xin., Email: zhounx301@163.com

Keywords：

Irreversible electroporation; Ultrasound-guided; Advanced hepatic carcinoma; Clinical efficacy

DOI：

10.7507/1007-9424.20160184

Video：

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Objective To study clinical efficacy of irreversible electroporation in the treatment of advanced hepatic carcinoma. Methods Between July 2015 and September 2015, 8 patients with advanced hepatic carcinoma (10 tumors) were treated by ultrasound-guided irreversible electroporation, using pertacuneous, laparoscope or open surgery in the Rockets Army General Hospital of PLA. Prospectively collected and summarized the clinical data. Finally, analyzed the therapeutic effect of irreversible electroporation. Results Compared with before treatment, the quality of life score significantly increased 〔(37.75±4.65) scores vs. (22.25±2.87) scores, P=0.000〕 in 3 months after treatment of irreversible electroporation, but value of serum total bilirubin (56.37 mmol/L vs. 150.40 mmol/L, P=0.046), direct bilirubin (58.69 mmol/L vs. 71.60 mmol/L, P=0.012), alanine aminotransferase 〔(52.63±12.14) U/mL vs. (87.28±27.94) U/mL, P=0.003〕, asperate aminotransferase 〔(48.45±13.75) U/mL vs. (74.40±21.09) U/mL, P=0.000〕, and alpha fetoprotein (82.10 ng/mL vs. 159.20 ng/mL, P=0.042) significantly decreased. One patient suffered from persistent upper abdominal pain after irreversible electroporation, but no serious complications, such as infection, biliary fistula, hemorrhage, and liver or kidney failure occurred in all 8 patients. Abdominal enhanced CT scanning or MRI in 3 months after irreversible electroporation showed complete ablation in 7 patients and incomplete ablation with some residual in 1 patient. Eight patients were followed up for 3-5 months 〔an average of (4.0±0.9) months〕. During follow-up period, all patients had been alive with 1 case of recurrence. Conclusion The effect of ultrasound-guided irreversible electroporation in the treatment of advanced hepatic carcinoma is remarkable, and it may deserve clinical application in consideration of its safety and efficacy.

Citation： LAILong-xiang, SUJuan, LUHao, CHENJun-zhou, ZHOUNing-xin.. Clinical Efficacy of Ultrasound-Guided Irreversible Electroporation in Treatment of Advanced Hepatic Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(6): 691-695. doi: 10.7507/1007-9424.20160184 Copy

1.	Lee YJ, Lu DS, Osuagwu F, et al . Irreversible electroporation in porcine liver: short- and long-term effect on the hepatic veins and adjacent tissue by CT with pathological correlation. Invest Radiol , 2012, 47(11): 671-675.
2.	Charpentier KP, Wolf F, Noble L, et al . Irreversible electroporation of the pancreas in swine: a pilot study. HPB (Oxford) , 2010, 12(5): 348-351.
3.	José A, Sobrevals L, Ivorra A, et al . Irreversible electroporation shows efficacy against pancreatic carcinoma without systemic toxicity in mouse models. Cancer Lett , 2012, 317(1): 16-23.
4.	Deodhar A, Monette S, Single GW Jr, et al . Renal tissue ablation with irreversible electroporation: preliminary results in a porcine model. Urology , 2011, 77(3): 754-760.
5.	Lee EW, Wong D, Kee ST. Irreversible electroporation (IRE) on liver tumors ablation: a summary of preclinical translational research. Clinical aspects of electroporation. Springer: New York , 2011: 219-230.
6.	Lee EW, Thai S, Kee ST. Irreversible electroporation: a novel image-guided cancer therapy. Gut Liver , 2010, 4(Suppl 1): S99-S104.
7.	Silk MT, Wimmer T, Lee KS, et al . Percutaneous ablation of peribiliary tumors with irreversible electroporation. J Vasc Interv Radiol , 2014, 25(1): 112-118.
8.	Niessen C, Jung EM, Wohlgemuth WA, et al . Irreversible electroporation of a hepatocellular carcinoma lesion adjacent to a transjugular intrahepatic portosystemic shunt stent graft. Korean J Radiol , 2013, 14(5): 797-800.
9.	Bagla S, Papadouris D. Percutaneous irreversible electroporation of surgically unresectable pancreatic cancer: a case report. J Vasc Interv Radiol , 2012, 23(1): 142-145.
10.	Eisele RM, Chopra SS, Glanemann M, et al . Risk of local failure after ultrasound guided irreversible electroporation of malignant liver tumors. Interv Med Appl Sci , 2014, 6(4): 147-153.
11.	Bertacchini C, Margotti PM, Bergamini E, et al . Design of an irreversible electroporation system for clinical use. Technol Cancer Res Treat , 2007, 6(4): 313-320.
12.	徐克成. 肿瘤消融新技术: 肿瘤消融新技术不可逆性电穿孔 . 上海: 上海科学技术文献出版社, 2014: 12.
13.	刘颖, 周玮, 熊正爱, 等. 不可逆性电穿孔致山羊肝脏组织凋亡与坏死的实验研究. 解放军医学杂志, 2011, 36(4): 356-360.
14.	周玮, 熊正爱, 刘颖, 等. 不可逆性电穿孔致HeLa细胞凋亡与坏死的作用研究. 第三军医大学学报, 2010, 32(18): 1941-1944.
15.	杨晓燕, 熊正爱, 李成祥, 等. 陡脉冲不可逆性电击穿治疗兔肝脏肿瘤研究. 西南大学学报: 自然科学版, 2009, 31(4): 120-125.
16.	中国科技网. 香港中文大学以“纳米刀”消灭肿瘤亚洲首例. 黑龙江科技信息, 2014, (1): Ⅳ.
17.	Al-Sakere B, Andre F, Bernat C, et al . Tumor ablation with irreversible electroporation. PLoS One , 2007, 2(11): e1135.
18.	Guo Y, Zhang Y, Klein R, et al . Irreversible electroporation therapy in the liver: longitudinal efficacy studies in a rat model of hepatocellular carcinoma. Cancer Res , 2010, 70(4): 1555-1563.
19.	Cheung W, Kavnoudias H, Roberts S, et al . Irreversible electroporation for unresectable hepatocellular carcinoma: initial experience and review of safety and outcomes. Technol Cancer Res Treat , 2013, 12(3): 233-241.
20.	Thomson K, Kee ST. Clinical research on irreversible electroporation of the liver. Clinical aspects of electroporation. Springer: New York , 2011: 237-246.
21.	Rubinsky B, Onik G, Mikus P. Irreversible electroporation: a new ablation modality—clinical implications. Technol Cancer Res Treat , 2007, 6(1): 37-48.
22.	Neal RE 2nd, Davalos RV. The feasibility of irreversible electroporation for the treatment of breast cancer and other heterogeneous systems. Ann Biomed Eng , 2009, 37(12): 2615-2625.
23.	Xiao D, Yao C, Liu H, et al . Irreversible electroporation and apoptosis in human liver cancer cells induced by nanosecond electric pulses. Bioelectromagnetics , 2013, 34(7): 512-520.
24.	Edd JF, Horowitz L, Davalos RV, et al . In vivo results of a new focal tissue ablation technique: irreversible electroporation. IEEE Trans Biomed Eng , 2006, 53(7): 1409-1415.
25.	Arena CB, Sano MB, Rossmeisl JH Jr, et al . High-frequency irreversible electroporation (H-FIRE) for non-thermal ablation without muscle contraction. Biomed Eng Online , 2011, 10: 102.
26.	来龙祥, 宿娟, 陈军周, 等. 肿瘤微创消融新技术——不可逆性电穿孔. 中国普外基础与临床杂志, 2016, 23(3): 365-368.

1. Lee YJ, Lu DS, Osuagwu F, et al . Irreversible electroporation in porcine liver: short- and long-term effect on the hepatic veins and adjacent tissue by CT with pathological correlation. Invest Radiol , 2012, 47(11): 671-675.
2. Charpentier KP, Wolf F, Noble L, et al . Irreversible electroporation of the pancreas in swine: a pilot study. HPB (Oxford) , 2010, 12(5): 348-351.
3. José A, Sobrevals L, Ivorra A, et al . Irreversible electroporation shows efficacy against pancreatic carcinoma without systemic toxicity in mouse models. Cancer Lett , 2012, 317(1): 16-23.
4. Deodhar A, Monette S, Single GW Jr, et al . Renal tissue ablation with irreversible electroporation: preliminary results in a porcine model. Urology , 2011, 77(3): 754-760.
5. Lee EW, Wong D, Kee ST. Irreversible electroporation (IRE) on liver tumors ablation: a summary of preclinical translational research. Clinical aspects of electroporation. Springer: New York , 2011: 219-230.
6. Lee EW, Thai S, Kee ST. Irreversible electroporation: a novel image-guided cancer therapy. Gut Liver , 2010, 4(Suppl 1): S99-S104.
7. Silk MT, Wimmer T, Lee KS, et al . Percutaneous ablation of peribiliary tumors with irreversible electroporation. J Vasc Interv Radiol , 2014, 25(1): 112-118.
8. Niessen C, Jung EM, Wohlgemuth WA, et al . Irreversible electroporation of a hepatocellular carcinoma lesion adjacent to a transjugular intrahepatic portosystemic shunt stent graft. Korean J Radiol , 2013, 14(5): 797-800.
9. Bagla S, Papadouris D. Percutaneous irreversible electroporation of surgically unresectable pancreatic cancer: a case report. J Vasc Interv Radiol , 2012, 23(1): 142-145.
10. Eisele RM, Chopra SS, Glanemann M, et al . Risk of local failure after ultrasound guided irreversible electroporation of malignant liver tumors. Interv Med Appl Sci , 2014, 6(4): 147-153.
11. Bertacchini C, Margotti PM, Bergamini E, et al . Design of an irreversible electroporation system for clinical use. Technol Cancer Res Treat , 2007, 6(4): 313-320.
12. 徐克成. 肿瘤消融新技术: 肿瘤消融新技术不可逆性电穿孔 . 上海: 上海科学技术文献出版社, 2014: 12.
13. 刘颖, 周玮, 熊正爱, 等. 不可逆性电穿孔致山羊肝脏组织凋亡与坏死的实验研究. 解放军医学杂志, 2011, 36(4): 356-360.
14. 周玮, 熊正爱, 刘颖, 等. 不可逆性电穿孔致HeLa细胞凋亡与坏死的作用研究. 第三军医大学学报, 2010, 32(18): 1941-1944.
15. 杨晓燕, 熊正爱, 李成祥, 等. 陡脉冲不可逆性电击穿治疗兔肝脏肿瘤研究. 西南大学学报: 自然科学版, 2009, 31(4): 120-125.
16. 中国科技网. 香港中文大学以“纳米刀”消灭肿瘤亚洲首例. 黑龙江科技信息, 2014, (1): Ⅳ.
17. Al-Sakere B, Andre F, Bernat C, et al . Tumor ablation with irreversible electroporation. PLoS One , 2007, 2(11): e1135.
18. Guo Y, Zhang Y, Klein R, et al . Irreversible electroporation therapy in the liver: longitudinal efficacy studies in a rat model of hepatocellular carcinoma. Cancer Res , 2010, 70(4): 1555-1563.
19. Cheung W, Kavnoudias H, Roberts S, et al . Irreversible electroporation for unresectable hepatocellular carcinoma: initial experience and review of safety and outcomes. Technol Cancer Res Treat , 2013, 12(3): 233-241.
20. Thomson K, Kee ST. Clinical research on irreversible electroporation of the liver. Clinical aspects of electroporation. Springer: New York , 2011: 237-246.
21. Rubinsky B, Onik G, Mikus P. Irreversible electroporation: a new ablation modality—clinical implications. Technol Cancer Res Treat , 2007, 6(1): 37-48.
22. Neal RE 2nd, Davalos RV. The feasibility of irreversible electroporation for the treatment of breast cancer and other heterogeneous systems. Ann Biomed Eng , 2009, 37(12): 2615-2625.
23. Xiao D, Yao C, Liu H, et al . Irreversible electroporation and apoptosis in human liver cancer cells induced by nanosecond electric pulses. Bioelectromagnetics , 2013, 34(7): 512-520.
24. Edd JF, Horowitz L, Davalos RV, et al . In vivo results of a new focal tissue ablation technique: irreversible electroporation. IEEE Trans Biomed Eng , 2006, 53(7): 1409-1415.
25. Arena CB, Sano MB, Rossmeisl JH Jr, et al . High-frequency irreversible electroporation (H-FIRE) for non-thermal ablation without muscle contraction. Biomed Eng Online , 2011, 10: 102.
26. 来龙祥, 宿娟, 陈军周, 等. 肿瘤微创消融新技术——不可逆性电穿孔. 中国普外基础与临床杂志, 2016, 23(3): 365-368.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Efficacy of Ultrasound-Guided Irreversible Electroporation in Treatment of Advanced Hepatic Carcinoma

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