Irreversible electroporation and electrochemotherapy in oncology: State of the art

Thermal tumor ablation techniques including radiofrequency, microwave, LASER, high-intensity focused ultrasound and cryoablation are routinely used to treated liver, kidney, bone, or lung tumors. However, all these techniques are thermal and can therefore be affected by heat sink effect, which can lead to incomplete ablation, and thermal injuries of non-targeted tissues are possible. Under certain conditions, high voltage pulsed electric field can induce formation of pores in the cell membrane. This phenomenon, called electro-permeabilization, is also known as electroporation. Under certain conditions, electroporation can be irre-versible, leading to cell death. Irreversible electroporation has demonstrated efficacy for the treatment of liver and prostate cancers, whereas data are scarce regarding pancreatic and renal cancers. During reversible electroporation, transient cell permeability can be used to introduce cytotoxic drugs into tumor cells (com-monly bleomycin or cisplatin). Reversible electroporation used in conjunction with cytotoxic drugs shows promise in terms of oncological response, particularly for solid cutaneous and subcutaneous tumors such as melanoma. Irreversible and reversible electroporation are both not thermal ablation techniques and there-fore open a new promising horizon for tumor ablation.(c) 2022 Societe francaise de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Automated summary

Thermal tumor ablation techniques have limitations due to heat sink effect, while electroporation opens new possibilities for tumor ablation by inducing cell death and enabling drug delivery.