Successful ablation of lymph nodes using irreversible electroporation (IRE) in a porcine survival model

Fritz, Stefan; Sommer, Christof M.; Longerich, Thomas; Kuhn-Neureuther, Clemens; Radeleff, Boris; Werner, Jens; Hackert, Thilo

doi:10.1007/s00423-017-1579-4

Cited by 5 publications

(2 citation statements)

References 52 publications

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“…The ablation of the colon [14], lymphaden [15], pancreatic tissue [16][17][18], gastric wall [19], epidural space of spine [20], liver [21], ureter [22], vertebrae [23] of the pig demonstrate the feasibility and security of IRE.…”

Section: Liver Cancermentioning

confidence: 99%

Cancer Treatments of the Irreversible Electroporation

Zhu¹,

Bao²,

Zhu³

et al. 2018

Int J Clin Res Trials

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Irreversible electroporation (IRE) is a kind of non-thermal tumor treatment strategy. Based on this, Nanoknife emerged, which is approved by FDA in 2011. From then on, clinical application of nanosecond electrical pulsed have showed an explosive growth. At the cell level, the biophysical mechanism of nonthermal irreversible electroporation of electrical pulsed was studied. At the animal level, it has studied the safety of irreversible electroporation and preclinical animal experiments, also the clinical application of irreversible electroporation. We reviewed Animal studies of IRE and Clinical application of IRE. Also traditional medical imaging methods such as CT, magnetic resonance imaging (MRI) and ultra-sound imaging can be used in the IRE therapy. The evidences can prove the beneficial effects and safety of IRE in tumor treatment and verify the potential of IRE in clinical treatment to some extent. However, larger clinical trials are still needed to confirm these conclusions. Hopefully, as we go deeper into IRE, we get a more thorough understanding of it and the application will appear in various fields.

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Section: Liver Cancermentioning

confidence: 99%

Cancer Treatments of the Irreversible Electroporation

Zhu¹,

Bao²,

Zhu³

et al. 2018

Int J Clin Res Trials

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“…Despite IRE's limitations in terms of lesion size and procedure length, it has shown promising results for the treatment of malignancies of the liver (Kourounis et al, 2017;Narayanan et al, 2013;Thomson, Kavnoudias & Neal, 2015), pancreas (Martin et al, 2016;Martin, 2013;Martin et al, 2015) and prostate cancer (Fritz et al, 2017;Murray et al, 2016;Narayanan, 2015). IRE selectively affects only the cell membrane, while the extracellular matrix in the treated region remains intact Phillips et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Toward a clinical real time tissue ablation technology: combining electroporation and electrolysis (E2)

Guenther

Klein

Mikus³

et al. 2020

PeerJ

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Background Percutaneous image-guided tissue ablation (IGA) plays a growing role in the clinical management of solid malignancies. Electroporation is used for IGA in several modalities: irreversible electroporation (IRE), and reversible electroporation with chemotoxic drugs, called electrochemotherapy (ECT). It was shown that the combination of electrolysis and electroporation—E2—affords tissue ablation with greater efficiency, that is, lower voltages, lower energy and shorter procedure times than IRE and without the need for chemotoxic additives as in ECT. Methods A new E2 waveform was designed that delivers optimal doses of electroporation and electrolysis in a single waveform. A series of experiments were performed in the liver of pigs to evaluate E2 in the context of clinical applications. The goal was to find initial parameter boundaries in terms of electrical field, pulse duration and charge as well as tissue behavior to enable real time tissue ablation of clinically relevant volumes. Results Histological results show that a single several hundred millisecond long E2 waveform can ablate large volume of tissue at relatively low voltages while preserving the integrity of large blood vessels and lumen structures in the ablation zone without the use of chemotoxic drugs or paralyzing drugs during anesthesia. This could translate clinically into much shorter treatment times and ease of use compared to other techniques that are currently applied.

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Safety and Effectiveness of Irreversible Electroporation in Lymph Node Metastases

Narayanan,

Mahendra,

Gentile

et al. 2024

Cardiovasc Intervent Radiol

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Purpose Demonstrating the safety and efficacy of percutaneous irreversible electroporation (IRE) for the treatment of lymph node metastases. Materials and Methods An IRB-approved, single-center retrospective review was performed on patients with lymph node metastases gastrointestinal, and genitourinary primary cancers. Primary objective safety was evaluated by assessing complications graded according to the Clavien-Dindo Classification, and efficacy was determined by tumor response on follow-up imaging and local progression-free survival (LPFS). Secondary outcome measures were technical success (complete ablation with an adequate ablative margin > 5 mm), length of hospital stay and distant progression-free survival (DPFS). Results Nineteen patients underwent percutaneous IRE between June 2018 and February 2023 for lymph node metastases, close to critical structures, such as vasculature, bowel, or nerves. The technical success was achieved in all cases. Complications occurred in four patients (21.1%), including two self-limiting grade 1 hematomas, a grade 1 abdominal pain, and grade 2 nerve pain treated with medication. Seventeen patients were hospitalized overnight, one patient stayed two nights and another patient stayed fourteen nights. Median follow-up was 25.5 months. Median time to local progression was 24.1 months (95% CI: 0–52.8) with 1-, 2-, and 5-year LPFS of 57.9%, 57.9% and 20.7%, respectively. Median time to distant progression was 4.3 months (95% CI: 0.3–8.3) with 1-, 2-, and 5-year DPFS of 31.6%, 13.2% and 13.2%, respectively. Conclusion IRE is a safe and effective minimally-invasive treatment for lymph node metastases in locations, where temperature dependent ablation may be contraindicated. Care should be taken when employing IRE near nerves. Graphical Abstract

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Successful ablation of lymph nodes using irreversible electroporation (IRE) in a porcine survival model

Abstract: This porcine survival model shows that IRE can safely and effectively be performed in lymph nodes. Thus, IRE might display a novel approach for therapy of lymph node metastasis. Further clinical studies are needed to evaluate the oncologic outcome of IRE ablation in lymph node metastasis.

Cited by 5 publications

References 52 publications

Cancer Treatments of the Irreversible Electroporation

Cancer Treatments of the Irreversible Electroporation

Toward a clinical real time tissue ablation technology: combining electroporation and electrolysis (E2)

Safety and Effectiveness of Irreversible Electroporation in Lymph Node Metastases

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