Electrochemotherapy in advanced pancreatic adenocarcinoma

Abstract

Background: Electrochemotherapy(ECT) is effective in treatment of various cutaneous tumors and could be translated into treatment of deep seated tumors. A prospective phase I/II study was conducted to evaluate feasibility, safety and efficacy of intraoperative ECT for locally advanced pancreatic adenocarcinoma. Secondary endpoint was to evaluate treatment response in terms of quantitative morphological and functional criteria based on Magnetic Resonance Imaging(MRI). Methods: 12 consecutive patients were enrolled. ECT with bleomycin was performed during open surgery, by insertion of electrodes into and around the tumor according to the individualized treatment plan. All patients underwent MRI and CT scan, before and after ECT treatment, using morphological and functional imaging. RECIST criteria were used to evaluate ECT response on CT and quantitative parameters were used to evaluate ECT response on MRI. Results: No acute and/or postoperative serious adverse events related to ECT were observed; no clinically significant electrocardiographic, hemodynamic, or serum biologic changes were noted. No clinically relevant elevation of amylase or lipase levels was observed in any patient and no bleeding or damage to surrounding viscera occured. Functional imaging based on MRI has shown more suitable to evaluate ECT response than CT. Conclusion: ECT of locally advanced pancreatic adenocarcinoma proved to be feasible, safe and effective. Dynamic and diffusion MRI seemed to be more suitable to assess ECT response than CT imaging.