Safety and early efficacy of irreversible electroporation for hepatic tumors in proximity to vital structures

Cannon, Robert M.; Ellis, Susan; Hayes, Donald F.; Narayanan, Govindarajan; Martin, Robert C.G.

doi:10.1002/jso.23280

Cited by 293 publications

(210 citation statements)

References 30 publications

Supporting

Mentioning

197

Contrasting

Unclassified

Order By: Relevance

“…In addition to the treatment of brain tumors, IRE has been implemented to treat human patients with prostate (21,22), pancreatic (23)(24)(25), liver (26)(27)(28), and kidney (29,30) tumors. Benefits of IRE therapy include elimination of cytotoxic effects, sharp delineation between treated and spared tissue, a nonthermal mechanism of ablation, treatment planning abilities, sparing of nerves and major blood vessels (31,32), and, if desired, it can be used as a combinatorial treatment with CT and/or RT.…”

Section: Irreversible Electroporationmentioning

confidence: 99%

Maximizing Local Access to Therapeutic Deliveries in Glioblastoma. Part III: Irreversible Electroporation and High-Frequency Irreversible Electroporation for the Eradication of Glioblastoma

2017

View full text Add to dashboard Cite

Glioblastoma (GBM) is the most common and aggressive primary brain tumor in adults. Approximately 9180 primary GBM tumors are diagnosed in the United States each year, in which median survival is up to 16 months. GBM eludes and resists typical cancer treatments due to the presence of infiltrative cells beyond the solid tumor margin, heterogeneity within the tumor microenvironment, and protection from the blood-brain barrier. Conventional treatments for GBM, such as surgical resection, radiotherapy, and chemotherapy, have shown limited efficacy;IRE and H-FIRE for the Eradication of GBM 374 therefore, alternate treatments are needed. Tumor chemoresistance and its proximity to critical structures make GBM a prime theoretical candidate for nonthermal ablation with irreversible electroporation (IRE) and high-frequency IRE (H-FIRE). IRE and H-FIRE are treatment modalities that utilize pulsed electric fields to permeabilize the cell membrane. Once the electric field magnitude exceeds a tissue-specific lethal threshold, cell death occurs. Benefits of IRE and H-FIRE therapy include, but are not limited to, the elimination of cytotoxic effects, sharp delineation from treated tissue and spared tissue, a nonthermal mechanism of ablation, and sparing of nerves and major blood vessels. Preclinical studies have confirmed the safety and efficacy of IRE and H-FIRE within their experimental scope. In this chapter, studies will be collected and information extrapolated to provide possible treatment regimens for use in high-grade gliomas, specifically in GBM.

show abstract

Section: Irreversible Electroporationmentioning

confidence: 99%

Maximizing Local Access to Therapeutic Deliveries in Glioblastoma. Part III: Irreversible Electroporation and High-Frequency Irreversible Electroporation for the Eradication of Glioblastoma

2017

View full text Add to dashboard Cite

show abstract

“…Usually, tumors assigned for IRE are declared unresectable and not suitable for thermal ablation due to the proximity to sensitive structures (e. g. nerves or bile ducts) [7]. Preprocedural imaging data are transferred to a pulse generator that calculates the position and number of probes based on a computer algorithm [18]. In the majority of trials, IRE was performed using NanoKnife (Angiodynamics) and configurations were set according to standard algorithms provided by the manufacturer.…”

Section: Clinical Considerationsmentioning

confidence: 99%

“…In the majority of trials, IRE was performed using NanoKnife (Angiodynamics) and configurations were set according to standard algorithms provided by the manufacturer. Usually, a series of 90 high-speed currents is administered with a duration of 20 -100 microseconds and up to 3000 V [18,19]. Consequently, a typical session takes less than 1 minute to treat a tumor 3 cm in diameter and approximately 3 to 5 min when additional ablations are performed [17].…”

Section: Clinical Considerationsmentioning

confidence: 99%

“…In terms of follow-up, standardized criteria have not yet been defined to predict successful ablation. However, in a number of clinical trials, tumor response to IRE was determined based on the Response Evaluation Criteria in Solid Tumors (RECIST) with welldemarcated hypoattenuating ablation zones indicating successful interventions [21,23] and new or persistent enhancement indicating incomplete ablation or local recurrence (LR) [18,19,21]. …”

Section: Clinical Considerationsmentioning

confidence: 99%

See 1 more Smart Citation

Irreversible Electroporation in Interventional Oncology: Where We Stand and Where We Go

Savic¹,

Chapiro²,

Hamm³

et al. 2016

Fortschr Röntgenstr

View full text Add to dashboard Cite

▶ Durch nicht-thermische Ablation können "heatsink-effect" und Koagulationsverletzungen unbeteiligter Strukturen umgangen werden. Abstract ▼Irreversible electroporation (IRE) is the latest in the series of image-guided locoregional tumor ablation therapies. IRE is performed in a nearly nonthermal fashion that circumvents the "heat sink effect" and allows for IRE application in proximity to critical structures such as bile ducts or neurovascular bundles, where other techniques are unsuitable. IRE appears generally feasible and initial reported results for tumor ablation in the liver, pancreas and prostate are promising. Additionally, IRE demonstrates a favorable safety profile. However, site-specific complications include bile leaking or vein thrombosis and may be more severe after pancreatic IRE compared to liver or prostate ablation. There is limited clinical evidence in support of the use of IRE in the kidney. In contrast, pulmonary IRE has so far failed to demonstrate efficacy due to practicability limitations. Hence, this review will provide a state-of-the-art update on available clinical evidence of IRE regarding feasibility, safety and oncologic efficacy. The future role of IRE in the minimally invasive treatment of solid tumors will be discussed.

show abstract

“…The technique also does not cause fibrosis and scarring after ablation, meaning that the treatment zone can be evaluated earlier than it can with other ablation methods 68 . However, ire requires the patient to be under general anesthesia and deep neuromuscular block in both open and ct-guided percutaneous procedures 71 . The use of ire in the management of hcc is still in its early stages, and no long-term results are available.…”

Section: 21mentioning

confidence: 99%

The Role of Interventional Radiology in the Management of Hepatocellular Carcinoma

Molla

Almenieir

Simoneau³

et al. 2014

Current Oncology

View full text Add to dashboard Cite

show abstract

Safety and early efficacy of irreversible electroporation for hepatic tumors in proximity to vital structures

Abstract: IRE appears to be a safe treatment for hepatic tumors in proximity to vital structures. Further prospective evaluation is needed to determine the optimal effectiveness of IRE in relation to size and technique for IRE of the liver.

Cited by 293 publications

References 30 publications

Maximizing Local Access to Therapeutic Deliveries in Glioblastoma. Part III: Irreversible Electroporation and High-Frequency Irreversible Electroporation for the Eradication of Glioblastoma

Maximizing Local Access to Therapeutic Deliveries in Glioblastoma. Part III: Irreversible Electroporation and High-Frequency Irreversible Electroporation for the Eradication of Glioblastoma

Irreversible Electroporation in Interventional Oncology: Where We Stand and Where We Go

The Role of Interventional Radiology in the Management of Hepatocellular Carcinoma

Contact Info

Product

Resources

About