NanoKnife Lawan Kanser

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NanoKnife^® provides a minimally invasive option for patients with inoperable or difficult-to-reach tumors, including tumors located near critical structures and major blood vessels in the body. Instead of using extreme heat or cold, which could damage normal adjacent tissues, the NanoKnife System uses electrical currents to destroy cancerous tumors.

Potential benefits of NanoKnife include:

No open incisions

Less damage to healthy tissue

Minimal postoperative pain

Fewer side effects

Short hospital stay

Quick post-operative recovery

Ability to repeat the procedure if new tumors develop

How it works

Instead of using microwave energy, extreme heat or extreme cold, the NanoKnife System uses electrical currents to treat tumors.

While the patient is under general anesthesia, the interventional radiologist carefully guides up to six thin needles (electrodes) into the patient’s body and strategically places them around the tumor. Then, the NanoKnife System sends electrical pulses or currents between each set of needles to puncture permanent nanometer-sized holes into the tumor. This process, called irreversible electroporation (IRE), causes the cancer cells to be unbalanced and triggers a cell “suicide,” thereby destroying the tumor.

The electrical pulses are contained between the electrodes, minimizing damage to surrounding healthy cell tissue, blood vessels and other important structures. After the tumor is destroyed, the body naturally rids itself of the dead cells, which are replaced with healthy cells.

The procedure lasts from two to four hours and is performed on an outpatient basis. The patient is also given antibiotics before and after the procedure to prevent infection.

NanoKnife may be a treatment option for patients who are not candidates for conventional treatments or if other treatments were not effective. Patients with a cardiac pacemaker, abnormal heartbeat or nerve stimulators are not eligible for this procedure.

Nanoknife Ablation Doubles Survival in Pancreatic Cancer

medscape

Irreversible electroporation (IRE) — a tissue ablation technique — appears to double median survival compared with historical controls for patients with locally advanced pancreatic cancer (LAPC), according to data extracted from six surgical centers in the United States. The results were published in the September issue of the Annals of Surgery.

"The appropriate and precise use of IRE in appropriately selected patients with locally advanced pancreatic cancer can result in a median overall survival close to 24 months, which is nearly double the survival rate with the best new chemotherapy and chemoradiotherapy," the investigators write in their discussion.

"This study demonstrates that IRE, in conjunction with standard of care, may substantially prolong the survival rates of patients with locally advanced pancreatic cancer," lead author Robert C. G. Martin II, MD, PhD, director of surgical oncology at the University of Louisville, Kentucky, said in a statement.

"While additional research is needed, ablation may represent an addition to the current standard of care for stage 3 pancreatic cancer patients whose only treatment options until now have been chemotherapy or a combination of chemoradiation therapy," he added.

IRE is a novel, nonthermal, tissue-ablation modality that delivers microsecond pulses of direct current to create permanent defects in cell membranes of targeted tissues and spares other tissues and connective tissue in blood vessels. In this study, IRE was delivered by the Nanoknife system (AngioDynamics).

The six surgical centers that participated in the study included the University of Louisville, the Cleveland Clinic, the Henry Ford Hospital in Detroit, the Piedmont Hospital in Atlanta, the Swedish Medical Center in Denver, and the Cancer Treatment Centers of America in Atlanta.

"This report of our 200-patient review is the single largest evaluation to date and further confirms the smaller series that have been published with the use of this treatment in patients with pancreatic adenocarcinoma," Dr Martin and colleagues write in their discussion.

Study Details

This was a registry study. Clinical data on patients treated for LAPC were retrieved from an institutional review board–approved, prospectively maintained soft tissue ablation registry.

Two hundred patients with confirmed LAPC first received induction therapy (chemotherapy, chemoradiation, or both) per institution protocol. Approximately 1 month after completion of induction treatment, patients were restaged with repeat triple-phase CT scan and serum tumor markers.

The decision to perform IRE with the Nanoknife system was made in appropriate patients. Patients' comorbidities, previous therapy, and intraoperative preresection margin assessment were used to determine whether surgical resection was possible; in these patients, IRE was used for tumor margin attenuation (n = 50).

"IRE was not used when an R2 resection could occur; and those patients underwent an IRE without resection," Dr Martin and investigators state. LAPC with IRE (in situ) was undertaken in 150 patients.