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H 1 Irreversible electroporation of liver malignancy: a new opportunity of curative treatment for patients not amenable to resection and thermal ablation

Auteurs : Seror, Olivier (Auteur de la Conférence)
CIRM (Editeur )

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    Résumé : Irreversible electroporation (IRE) is the sole physical ablative technology inducing tumorous cell death by process unrelated to thermal effect. This characteristic makes the technique suitable for the treatment of subtypes of liver tumors especially hepatocellular carcinoma (HCC) located next to critical structures leading to contraindications to thermal ablation like radiofrequency, microwave or cryotherapy. However, while IRE appears safe in such assumed challenging cases for thermal techniques, several issues remain to be addressed to make its use easier and more effective in clinical practice. First of all, tissue changes induced by IRE must be assessed keeping in mind that conversely to thermal techniques its efficacy is not limited to observable coagulative necrotic component of treatment zone. In addition, IRE which is multibipolar ablative technology requires meticulous demanding electrodes positioning to ensure proper magnitude of electric fields between each dipole. Finally, numerical simulations of IRE are mandatory to ease the setting of electrical pulses parameters to improve predictability of treatment in each individual case. In this setting of continue efforts to improve practicability of IRE the technique is routinely used in our institution since several years for the treatment of patients bearing early and locally advanced HCC not amenable to resection or thermal ablation. All along our experience with IRE, imaging appeared as a key point for addressing the specific issues listed above. For the 58 first patients 92% of complete ablation were achieved while the one-year local tumor progression free survival was 70% (95% CI: 56%, 81%). Indeed, despite the need of improvements IRE appears right now as a unique opportunity to achieve complete sustained local tumor control for patient bearing early or locally advanced HCC not amenable to other curative treatments.

    Keywords : cell membrane; irreversible electroporation; tissue ablation; hepatocellular carcinoma

    Codes MSC :
    78A70 - Biological applications of optics and electromagnetic theory
    80A20 - Heat and mass transfer, heat flow
    92C37 - Cell biology
    92C50 - Medical applications of mathematical biology

      Informations sur la Vidéo

      Langue : Anglais
      Date de publication : 30/07/2018
      Date de captation : 18/07/2018
      Collection : Research School ; Mathematics in Science and Technology
      Format : MP4
      Durée : 01:03:27
      Domaine : Mathematics in Science & Technology
      Audience : Chercheurs ; Doctorants , Post - Doctorants ; Etudiants Science Cycle 2
      Download : https://videos.cirm-math.fr/2018-07-18_Seror.mp4

    Informations sur la rencontre

    Nom de la rencontre : CEMRACS - Summer school: Numerical and mathematical modeling for biological and medical applications: deterministic, probabilistic and statistical descriptions / CEMRACS - École d'été : Modélisation numérique et mathématique pour la biologie et la médecine : descriptions déterministes, probabilistes et statistiques
    Organisateurs de la rencontre : Calvez, Vincent ; Grandmont, Céline ; Löcherbach, Eva ; Poignard, Clair ; Ribot, Nathalie ; Vauchelet, Nicolas
    Dates : 16/07/2018 - 24/08/2018
    Année de la rencontre : 2018
    URL Congrès : https://conferences.cirm-math.fr/1834.html

    Citation Data

    DOI : 10.24350/CIRM.V.19422503
    Cite this video as: Seror, Olivier (2018). Irreversible electroporation of liver malignancy: a new opportunity of curative treatment for patients not amenable to resection and thermal ablation. CIRM. Audiovisual resource. doi:10.24350/CIRM.V.19422503
    URI : http://dx.doi.org/10.24350/CIRM.V.19422503


    Voir aussi

    Bibliographie

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    2. Kirsch, S.A., & Böckmann, R.A. (2016). Membrane pore formation in atomistic and coarse-grained simulations. Biochimica et Biophysica Acta, 1858(10), 2266-2277 - https://doi.org/10.1016/j.bbamem.2015.12.031

    3. Sutter, O., Calvo, J., N’Kontchou, G., Nault, J.-C., Ourabia, R., Nahon, P., Ganne-Carrié, N., Bourcier, V., Zentar, N., Bouhafs, F., Sellier, N., Diallo, A., & Seror, O. (2017). Safety and efficacy of irreversible electroporation for the treatment of hepatocellular carcinoma not amenable to thermal ablation techniques: a retrospective single-center case series. Radiology, 284(3), 877-886 - https://doi.org/10.1148/radiol.2017161413

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