ABSTRACT
OBJECTIVE: To determine the feasibility of irreversible electroporation (IRE) for locally advanced pancreatic adenocarcinoma. MATERIAL AND METHODS: Twenty-three patients underwent IRE after chemotherapy for locally advanced pancreatic cancer between 2015 and 2022. IRE was performed during laparotomy as a rule (n=22). In one case, IRE was combined with palliative pancretoduodenectomy. Nineteen (86.3%) patients received adjuvant chemotherapy after the procedure. The follow-up examination included contrast-enhanced CT/MRI of the abdomen, chest X-ray or CT, analysis of CA 19-9 marker one month after surgery and then every three months. RESULTS: Complications after IRE developed in 5 (21.7%) patients. Three patients (13.0%) had arrhythmia, two (8.7%) ones had pancreatic necrosis. A 90-day mortality after the procedure was 4.3% (n=1), the cause was pancreatic necrosis. According to intraoperative data and the first examination (CT/MRI), the entire tumor infiltrate was treated in 21 (91.3%) cases. Median follow-up was 19 months. Median period until local recurrence was 15 months. Isolated local recurrence was observed in 7 patients. Of these, 3 ones underwent radiotherapy, one patient underwent repeated IRE. Distant metastases were found in 11 patients; systemic therapy was restarted. Median time to progression was 7 months after IRE and 14 months after initiation of chemotherapy. The median overall survival was 16 months after electroporation and 25 months after chemotherapy. CONCLUSION: Irreversible electroporation may be useful in carefully selected patients with unresectable locally advanced pancreatic adenocarcinoma after successful induction chemotherapy. This procedure provides local control, but the impact on long-term outcomes and feasibility of routine use should be analyzed in randomized trials.
Subject(s)
Adenocarcinoma , Pancreatic Neoplasms , Pancreatitis, Acute Necrotizing , Humans , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/therapy , Treatment Outcome , Adenocarcinoma/diagnosis , Adenocarcinoma/therapy , Electroporation/methods , Pancreatic NeoplasmsABSTRACT
This paper provides the results of POM, DSC and XRPD methods characterizing the liquid crystalline behaviour, thermal properties and structural parameters of lyotropic systems based on a nonionic surfactant and lanthanum nitrate (La(3+)). The systems based on tetraethylene glycol monododecyl ether (C12EO4) and lanthanum nitrate have been demonstrated to form a lamellar phase. The concentration and temperature ranges of the existence of mesophases as well as thermodynamic parameters of phase transitions have been estimated. The structural parameters of the lamellar phase of the C12EO4/La(3+)/water systems have been determined using X-ray diffraction. The model of molecular packing in lamellar lanthanide-containing lyotropic mesophases was proposed for the observed patterns of structural parameters obtained at various water contents. NMR (1)H with a pulsed magnetic field gradient has been used to characterize molecular motions in the C12EO4/La(3+)/H2O systems with different water contents.
ABSTRACT
The paper gives information on current approaches to diagnosing and treating intrahepatic cholangiocarcinoma (IHC), its microscopic and macroscopic varieties. It details the specific features of images of IHC by ultrasonography, X-ray computed tomography, magnetic resonance imaging (MRI), including those by diffusion-weighted MRI. Dynamic intravenous contrast enhancement and analysis of tumor hemodynamic features are emphasized to play a crucial role in different examination (arterial, venous, and delayed) phases. Diffuse heterogeneous enhancement of the whole volume of the tumor in the arterial phase with pronounced peripheral and progressing centripetal enhancement in ensuing phases is considered to be the most common type of an IHC image, which can recognize with confidence this comparatively rare neoplasm.
