关键词: 胰腺癌, 纳米刀, 联合, 药物疗法, 临床疗效

Abstract: Objective To evaluate the clinical safety and efficacy of IRE ablation combined with PD⁃1 in⁃ hibitors and chemotherapy in the treatment of locally advanced pancreatic cancer（LAPC）. Methods The clini⁃ cal data of 26 patients with LAPC who were hospitalized in the Fifth Affiliated Hospital of Zhengzhou University from May 2019 to December 2020 were collected and divided into 11 patients treated with IRE combined with PD⁃1 inhibitor and chemotherapy group as study group and 15 patients treated with IRE combined with chemotherapy as control group according to postoperative treatment. The chemotherapy regimens for all the patients were mFOLFIRI⁃ NOX. The two groups were compared in terms of postoperative complications，adverse reactions during adjuvant therapy，CA19⁃9 and FACT⁃G scores at different time points before and after surgery，disease control 6 months af⁃ ter surgery，median overall survival（OS）and median progression⁃free survival（PFS）during follow⁃up. Results No complications of Clavien⁃Dindo of grade ⅡI or above occurred in both groups within one month after surgery， and there was no statistical significance in the incidence of other complications between them（P>0.05）. No ad⁃ verse reactions of grade 3 or above occurred between the two groups during the postoperative adjuvant therapy，and there was no statistical significance in the incidence of other adverse reactions between them（P>0.05）. The level of CA19⁃9 in the two groups showed an overall decreasing trend 1 and 4 months after surgery，and the difference was statistically significant compared with that before surgery（P<0.05）. The level of CA19⁃9 in the two groups be⁃tween 1 and 4 months after surgery was statistically significantly decreased compared with that before surgery（P< 0.05）. The FACT⁃G scores of the two groups showed an overall increasing trend 1 month and 4 months after sur⁃ gery，with statistical significance compared with that before surgery（P<0.05）. There were no significant differenc⁃ es in disease remission rate（RR）and disease control rate（DCR）between the two groups 6 months after surgery （P>0.05）. The median OS and PFS of the study group were significantly higher than those of the control group（24 months vs 18 months；14 months vs10 months）（P<0.05）. Conclusion IRE combined with PD⁃1 inhibitor and chemotherapy is safe in the treatment of LAPC. It can prolong the survival time and improve the quality of life of pa⁃ tients. 

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