Irreversible electroporation and electrochemotherapy in oncology: State of the art - 03/11/22
, David Tougeron c, Marie-Pierre Rols dHightlights |
• | Irreversible electroporation leads to cell apoptosis and can be used to treat liver, kidney, pancreatic or prostate tumors with effective tumor necrosis. |
• | Reversible electroporation allows delivering cytotoxic drugs such as bleomycin and cisplatin, and inducing cell death by apoptosis, a process called electrochemotherapy. |
• | Electrochemotherapy can be used to treat solid cutaneous and subcutaneous tumors, such as melanoma, basal cell carcinoma and squamous cell carcinoma. |
• | Electric fields used in irreversible electroporation and electrochemotherapy respect collagenic structure of the surrounding tissue offering promising options for tumor ablation particularly those in complex anatomic localizations. |
Abstract |
Thermal tumor ablation techniques including radiofrequency, microwave, LASER, high-intensity focused ultrasound and cryoablation are routinely used to treated liver, kidney, bone, or lung tumors. However, all these techniques are thermal and can therefore be affected by heat sink effect, which can lead to incomplete ablation, and thermal injuries of non-targeted tissues are possible. Under certain conditions, high voltage pulsed electric field can induce formation of pores in the cell membrane. This phenomenon, called electropermeabilization, is also known as “electroporation”. Under certain conditions, electroporation can be irreversible, leading to cell death. Irreversible electroporation has demonstrated efficacy for the treatment of liver and prostate cancers, whereas data are scarce regarding pancreatic and renal cancers. During reversible electroporation, transient cell permeability can be used to introduce cytotoxic drugs into tumor cells (commonly bleomycin or cisplatin). Reversible electroporation used in conjunction with cytotoxic drugs shows promise in terms of oncological response, particularly for solid cutaneous and subcutaneous tumors such as melanoma. Irreversible and reversible electroporation are both not thermal ablation techniques and therefore open a new promising horizon for tumor ablation.
Le texte complet de cet article est disponible en PDF.Keywords : Electroporation, Electrochemotherapy, Cancer treatment, Interventional oncology
Abbreviations : ECT, FOLFIRINOX, IL, IRE, IT, IV
Plan
Vol 103 - N° 11
P. 499-509 - novembre 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
