[Irreversible electroporation: local, non-thermal, ablation therapy of malignant tumours].

BACKGROUND: Irreversible electroporation (IRE) is a new method of local therapy of malign tumours based on bioelectric effect of electrical current. Short electric pulses with high voltage create nano size-pores in tumour cell membranes resulting in apoptosis of the exposed cells. The purpose of our study was to verify the IRE technique performed percutaneously under CT navigation and to assess effects of application of this method in early stages of primary and secondary hepatic, pancreatic, renal and pulmonary tumours.

METHODS AND RESULTS: From November 2011 to October 2012 IRE was performed with NanoKnife (by AngioDynamics) in the population of 15 patients - 6 males and 9 females. IRE was performed under total anaesthesia with 2-5 needle electrodes introduced under CT navigation in the tumour base. The results of the treatment were assessed on the basis of modified RECIST criteria applied in 1-, 3- and 6-month intervals. A control CT or MRI examination 6 months post IRE was undertaken by 10 patients. One patient died one month post IRE of pulmonary embolism, two refused to visit for the control examination and another two are still to undergo the examination after 6 months. Out of the 10 examined patients success of IRE was demonstrated in 7 cases (70.0%) and IRE failure in 3 patients (30.0%).

CONCLUSION: IRE is a new, mini-invasive therapeutic method applicable to local treatment of malignant tumours in cases where surgical approach is technically unfeasible or excessively risky. On the basis of first experience in a small cohort of patients IRE performed under CT navigation appears to be an effective and safe ablation method with a large therapeutic potential. Its results will however need to be assessed within a longer time horizon and in a larger cohort of population.