Abstract
Modern medicine is constantly develo** less invasive methods for treatment of disease. While some of the research regarding tissue ablation was documented over 100 years ago, the majority of the investigative efforts have taken place within the past 20 years. Since its first introduction in 1990, the efficacy of thermal ablation techniques, such as radiofrequency ablation (RFA) and microwave ablation (MWA), has greatly improved due to technological advancements in image guidance, resulting in real-time tumor localization and accurate needle targeting. Technical advances of the thermal devices such as the development of more powerful generators and better-quality probe designs have further improved the efficacy, creating larger, more spherical, and more predictable ablation zones. In the rapidly changing climate of tumor ablation, irreversible electroporation (IRE) is the newest kid on the block. Over the past years, IRE has been increasingly used in clinical practice because the hypothetical advantages over thermal ablation seem intuitive and self-evident. However, hard evidence regarding the actual working mechanism and – more importantly – regarding the established safety and efficacy is lacking and conclusions drawn from the available data may very well be prejudiced
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Qin Z, et al. Irreversible electroporation: an in vivo study with dorsal skin fold chamber. Ann Biomed Eng. 2013;41(3):619–29.
Silk M, et al. The state of irreversible electroporation in interventional oncology. Semin Interv Radiol. 2014;31(2):111–7.
Appelbaum L, et al. Irreversible electroporation ablation: creation of large-volume ablation zones in in vivo porcine liver with four-electrode arrays. Radiology. 2014;270(2):416–24.
Ivorra A, Rubinsky B. In vivo electrical impedance measurements during and after electroporation of rat liver. Bioelectrochemistry. 2007;70(2):287–95.
Ivorra A, et al. In vivo electrical conductivity measurements during and after tumor electroporation: conductivity changes reflect the treatment outcome. Phys Med Biol. 2009;54(19):5949–63.
Dunki-Jacobs EM, Philips P, Martin RC 2nd. Evaluation of resistance as a measure of successful tumor ablation during irreversible electroporation of the pancreas. J Am Coll Surg. 2014;218(2):179–87.
Pavliha D, et al. Planning of electroporation-based treatments using web-based treatment-planning software. J Membr Biol. 2013;246(11):833–42.
Scheffer HJ, et al. Ablation of colorectal liver metastases by irreversible electroporation: results of the COLDFIRE-I ablate-and-resect study. Eur Radiol. 2014;24(10):2467–75.
Eller A, et al. Local control of perivascular malignant liver lesions using percutaneous irreversible electroporation: initial experiences. Cardiovasc Intervent Radiol. 2015;38(1):152–9.
Cannon R, et al. Safety and early efficacy of irreversible electroporation for hepatic tumors in proximity to vital structures. J Surg Oncol. 2013;107(5):544–9.
Kingham TP, et al. Ablation of perivascular hepatic malignant tumors with irreversible electroporation. J Am Coll Surg. 2012;215(3):379–87.
Silk MT, et al. Percutaneous ablation of peribiliary tumors with irreversible electroporation. J Vasc Interv Radiol. 2014;25(1):112–8.
Scheffer HJ, et al. Colorectal liver metastatic disease: efficacy of irreversible electroporation – a single-arm phase II clinical trial (COLDFIRE-2 trial). BMC Cancer. 2015;15:772.
Paiella S, et al. Safety and feasibility of irreversible electroporation (IRE) in patients with locally advanced pancreatic cancer: results of a prospective study. Dig Surg. 2015;32(2):90–7.
Martin RC 2nd, et al. Irreversible electroporation therapy in the management of locally advanced pancreatic adenocarcinoma. J Am Coll Surg. 2012;215(3):361–9.
Narayanan G, et al. Percutaneous irreversible electroporation for downstaging and control of unresectable pancreatic adenocarcinoma. J Vasc Interv Radiol. 2012;23(12):1613–21.
Faris JE, et al. FOLFIRINOX in locally advanced pancreatic cancer: the Massachusetts General Hospital cancer Center experience. Oncologist. 2013;18(5):543–8.
Hosein PJ, et al. A retrospective study of neoadjuvant FOLFIRINOX in unresectable or borderline-resectable locally advanced pancreatic adenocarcinoma. BMC Cancer. 2012;12:199.
Suker M, et al. FOLFIRINOX for locally advanced pancreatic cancer: a systematic review and patient-level meta-analysis. Lancet Oncol. 2016;17(6):801–10.
Von Hoff DD, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 2013;369(18):1691–703.
Loehrer PJ Sr, et al. Gemcitabine alone versus gemcitabine plus radiotherapy in patients with locally advanced pancreatic cancer: an Eastern Cooperative Oncology Group trial. J Clin Oncol. 2011;29(31):4105–12.
Gurka MK, et al. Stereotactic body radiation therapy with concurrent full-dose gemcitabine for locally advanced pancreatic cancer: a pilot trial demonstrating safety. Radiat Oncol. 2013;8:44.
Berber B, et al. Emerging role of stereotactic body radiotherapy in the treatment of pancreatic cancer. Expert Rev Anticancer Ther. 2013;13(4):481–7.
Lax I, et al. Stereotactic radiotherapy of malignancies in the abdomen. Methodological aspects. Acta Oncol. 1994;33(6):677–83.
Auriemma WS, et al. Locally advanced pancreatic cancer. Semin Oncol. 2012;39(4):e9–22.
Matsuo K, et al. The Blumgart preoperative staging system for hilar cholangiocarcinoma: analysis of resectability and outcomes in 380 patients. J Am Coll Surg. 2012;215(3):343–55.
Ruys AT, et al. Long-term survival in hilar cholangiocarcinoma also possible in unresectable patients. World J Surg. 2012;36(9):2179–86.
Darwish Murad S, et al. Predictors of pretransplant dropout and posttransplant recurrence in patients with perihilar cholangiocarcinoma. Hepatology. 2012;56(3):972–81.
Melenhorst MC, et al. Percutaneous irreversible electroporation of Unresectable hilar cholangiocarcinoma (Klatskin tumor): a case report. Cardiovasc Intervent Radiol. 2016;39(1):117–21.
Neal RE 2nd, et al. In vitro and numerical support for combinatorial irreversible electroporation and electrochemotherapy glioma treatment. Ann Biomed Eng. 2014;42(3):475–87.
Rombouts SJ, et al. Systematic review of innovative ablative therapies for the treatment of locally advanced pancreatic cancer. Br J Surg. 2015;102(3):182–93.
Meijerink MR, et al. Percutaneous irreversible electroporation for recurrent thyroid cancer – a case report. J Vasc Interv Radiol. 2015;26(8):1180–2.
Bonakdar M, et al. Electroporation of brain endothelial cells on chip toward permeabilizing the blood-brain barrier. Biophys J. 2016;110(2):503–13.
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Meijerink, M.R., Scheffer, H.J., Naranayan, G. (2018). Future Perspectives of IRE. In: Meijerink, M., Scheffer, H., Narayanan, G. (eds) Irreversible Electroporation in Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-319-55113-5_18
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