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Irreversible electroporation versus radiofrequency ablation for malignant hepatic tumor:A prospective single-center double-arm trial

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Journal of Interventional Medicine 2022年第2期5卷 89-94页

作者： Boyu Liu Dianxun Fu Yong Fan Zhe Wang Xu Lang Department of Radiology Tianjin Medical University General HopitalAnshan Rood 154#Heping DitricTianjin300052China

Objective:Irreversible electroporation(IRE)is a nonthermal ablation technique for the treatment of malignant liver *** has demonstrated efficacy and safety in the treatment of malignant liver tumors and its unique advantages in the treatment of nearby vascular *** study aimed to compare the efficacy,safety,and intermediate-term outcomes of IRE and radiofrequency(RF)therapy in malignant liver ***:Twenty-four patients with primary or secondary liver malignancies were included in this prospective,double-arm clinical *** were randomly divided into the IRE and RF *** primary outcome was the efficacy(local ablation control evaluation at 90 days).The secondary outcomes were safety(procedure-related complications at≤90 days)and intermediate-term survival(at 24 months).Results:The ablation assessment at 90 days after surgery with m RECIST for IRE versus RF were 70%,20%,0%,and 10%versus 92.9%,7.1%,0%,and 0%(CR,PR,SD,and PD,respectively).The complication rates of IRE versus RF with Clavien-Dindo classification were 16.7%,25%,0%,8.3%,and 8.3%versus 8.3%,50%,0%,0%,and 0%(Grade I,II,Ⅲ,IV,and V,respectively).The average overall survival(OS)was 17.55 months in the IRE group(95%CI 15.13-22.37)and 18.75 months in the RF group(95%CI 12.48-22.61).There was no statistical difference between the IRE and RF groups in terms of efficacy(p=0.48),safety(p=0.887),or 24-month OS(p=0.959).Conclusions:IRE ablation revealed similar efficacy and safety in a short-term follow-up,and similar OS in midterm survival as RF ablation in treating malignant hepatic tumors.

关键词： Irreversible electroporation Radiofrequency ablation Efficacy Intermediate-term survival prospective trial

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Feasibility of personalized treatment concepts in gastrointestinal malignancies： Sub-group results of prospective clinical phase Ⅱ trial EXACT

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Chinese Journal of Cancer Research 2018年第5期30卷 508-515页

作者： Matthias Unseld Robert Mader Lukas Baumann Clarence Veraar Fritz Wrba Fredrik Waneck Markus Kieler Daniela Bianconi Walter Berger Maria Sibilia Leonhard Miillauer Christoph Zielinski Gerald W. Prager Department of Medicine I Division of Oncology Medical University of Vienna Vienna 1090 Austria Comprehensive Cancer Center Medical University Vienna - General Hospital Vienna 1090 Austria Department of Medical Statistics Medical University of Vienna Vienna 1090 Austria Clinical Institute of Pathology Medical University of Vienna Vienna 1090 Austria Department of Interventional Radiology Medical University of Vienna Vienna 1090 Austria Department of Medicine I Institute of Cancer Research Medical University of Vienna Vienna 1090 Austria

Objective： Advances in high-throughput genomic profiling and the development of new targeted therapies improve patient＇s survival. In gastrointestinal （GI） malignancies, the concept of personalized medicine （PM） was not investigated so far. The aim of this prospective study was to evaluate the efficacy of a personalized treatment in GI patients who failed standard treatment. Methods： Out of the original prospective clinical phase II EXACT trial, 21 （38%） GI cancer patients who had no further treatment options were identified. A molecular profile （MP） via a 50 gene next generation sequencing （NGS） panel in combination with immunohistochemistry （IHC） was conducted using real-time biopsy tumor material. Results were discussed by a multidisciplinary team （MDT） to translate the individual MP in an experimental treatment. Results： Of the 55 patients originally included in the EXACT trial, 21 （38%） suffered from GI malignancies. The final analysis showed that 15 （71%） patients had experienced a longer progression-free survival （PFS） upon experimental targeted treatment （124 d, quartiles 70/193 d）, when compared with the PFS achieved by the previous conventional therapy （62 d, quartiles 55/83 d）（P=0.014）. Thirteen （62%） patients receiving targeted treatment experienced a disease control according to Response Evaluation Criteria in Solid Tumors （RECIST）. Median overall survival （OS） from the start of experimental therapy to time of censoring or death was 193 d （quartiles 115/374 d）. Conclusions： PM was not investigated in GI malignancies so far in a prospective trial. This study shows that treatment based on real-time molecular tumor profiling led to a superior clinical benefit, and survival as well as response was significantly improved when compared with previous standard medications.

关键词： Personalized medicine gastrointestinal malignancies prospective trial next generations sequencing

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