Development of hybrid surgery using irreversible electroporation (IRE) in pancreatic cancer

• Project/Area Number: 16K10611
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Digestive surgery
• Research Institution: Tokyo Medical University
• Principal Investigator: Nagakaawa Yuichi 東京医科大学, 医学部, 准教授 (20349484)
• Co-Investigator(Kenkyū-buntansha): 杉本 勝俊 東京医科大学, 医学部, 准教授 (20385032) ; 山口 浩 東京医科大学, 医学部, 准教授 (20510697) ; 土田 明彦 東京医科大学, 医学部, 主任教授 (50207396) ; 瀧下 智恵 東京医科大学, 医学部, 助教 (60774544)
• Research Collaborator: Itoi Takao ; Haga Sanae
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2017: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000); Fiscal Year 2016: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
• Keywords: 膵癌 / 不可逆電気穿孔法 / IRE / 集学的治療 / 膵切除 / ハイブリッド手術 / 切除不能膵癌 / Borderline resectable膵癌

Outline of Final Research Achievements

We conducted a basic study using pigs to investigate the optimal treatment conditions for IRE. Based on that data, we performed a pilot-study of IRE treatment for patients with local advanced unresectable pancreatic cancer. Although the tumor shrank in all cases after IRE, the progression of cancer was observed in all cases. However, local progression in cases without distant metastasis was 12.0(8.5-15.3) months. In cases where distant metastasis can be controlled by chemotherapy, the effect of IRE treatment can be expected.

Academic Significance and Societal Importance of the Research Achievements

本研究では基礎的研究において膵癌治療におけるIREの最適な治療条件を同定することができた．また臨床研究の結果から局所進行切除不能膵癌においてIRE治療による局所コントロールは良好であり，化学療法にて遠隔転移が制御できる症例においてはIRE後に切除を行うことで更なる治療成績向上に繋がる可能性が示唆された．本研究結果はIREと切除のハイブリッド手術が将来的に有用となる可能性を示したと思われる．

Research Products

• [Journal Article] Neoadjuvant Therapy for Borderline Resectable Pancreatic Cancer: Is Combined Radiotherapy Necessary? (2019)
  • Author(s): Nagakawa Yuichi
  • Journal Title: Annals of Surgical Oncology Volume: 26 Issue: 6 Pages: 1637-1638
  • DOI: 10.1245/s10434-019-07245-7
  • Peer Reviewed
• [Journal Article] Irreversible Electroporation for Nonthermal Tumor Ablation in Patients with Locally Advanced Pancreatic Cancer: Initial Clinical Experience in Japan (2018)
  • Author(s): Sugimoto Katsutoshi、Moriyasu Fuminori、Tsuchiya Takayoshi、Nagakawa Yuichi、Hosokawa Yuichi、Saito Kazuhiro、Tsuchida Akihiko、Itoi Takao
  • Journal Title: Internal Medicine Volume: 57 Issue: 22 Pages: 3225-3231
  • DOI: 10.2169/internalmedicine.0861-18
  • NAID: 130007511592
  • ISSN: 0918-2918, 1349-7235
  • Year and Date: 2018-11-15
  • Peer Reviewed
• [Journal Article] Surgical Outcomes of Pancreaticoduodenectomy for Pancreatic Cancer with Proximal Dorsal Jejunal Vein Involvement. (2018)
  • Author(s): Hosokawa Y, Nagakawa Y, Sahara Y, Takishita C, Nakajima T, Hijikata Y, Osakabe H, Shirota T, Saito K, Yamaguchi H, Inoue K, Katsumata K, Tsuchiya T, Sofuni A, Itoi T, Tsuchida A.
  • Journal Title: J Gastrointest Surg. Volume: 22 Issue: 7 Pages: 1179-1185
  • DOI: 10.1007/s11605-018-3722-0
  • Peer Reviewed