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Advanced Ultrasound in Diagnosis and Therapy ›› 2025, Vol. 9 ›› Issue (4): 426-436.doi: 10.26599/AUDT.2025.250099

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  • 收稿日期:2025-08-17 修回日期:2025-08-28 接受日期:2025-09-02 出版日期:2025-12-30 发布日期:2025-11-06

Pulse Field Ablation in Oncology: Current Progress and Future Directions

Xie Litinga, Zhang Chengyuea, Lou Wenjinga, Xu Fana, Ma Wenyuana, Jiang Tian’ana,*()   

  1. aDepartment of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
  • Received:2025-08-17 Revised:2025-08-28 Accepted:2025-09-02 Online:2025-12-30 Published:2025-11-06
  • Contact: Department of Ultrasound Medicine, The First Affiliated hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China (Tian’an Jiang), e-mail: tiananjiang@zju.edu.cn (TA J).

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Abstract:

Pulsed field ablation (PFA), a non-thermal ablation technique that induces cell death via irreversible electroporation, has emerged as a promising therapeutic strategy for treating tumors located in anatomically complex regions. This review comprehensively examines recent developments in PFA, including its mechanisms foundations, established clinical applications in pancreatic, prostate and liver cancer, and expanding utility with other tumors, etc. Furthermore, we discuss synergistic approaches combining PFA with chemotherapy, immunotherapy, surgery and radiotherapy to augment therapeutic outcomes. In addition, technological innovations—such as robotic assistance, magnetic anchoring, and artificial intelligence—that improve precision and reproducibility are also explored. Despite encouraging clinical results, broader implementation of PFA necessitates higher-quality evidence from large-scale randomized trials and standardized treatment protocols. This review highlights the transformative potential of PFA in oncology while addressing contemporary challenges and future research directions to facilitate clinical translation.

Key words: Pulsed field ablation, Irreversible electroporation, Tumor ablation, Clinical applications

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Author (year of publication)No. of patientsApproachMedian age (y)Tumor typeMedian follow-up (mo)Median overall survival (mo)
LAPC, locally advanced pancreatic cancer; CRLMs, colorectal liver metastases; HCC, hepatocellular carcinoma; PCa, localized prostate cancer; NA, not available
Pancreatic cancer
Martin et al. (2015) [4]200open61LAPC2928
Holland et al. (2019) [15]152open62LAPC1931
Ruarus et al. (2020) [7]50percutaneous61LAPCNA17
Martin et al. (2024) [16]87open64LAPCNANA
Prostate Cancer
Wang et al. (2022) [5]117percutaneous67PCa6NA
Zhang et al. (2023) [18]106percutaneous64PCa30NA
George et al. (2025) [20]121percutaneous67PCa12NA
Liver Cancer
Meijerink et al. (2021) [22]51percutaneous67CRLMsNA32
Xu et al. (2025) [6]192percutaneous59HCC34NA

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System categoryDisease/conditionAuthor (year of publication)Study typeNo. of patientsMedian overall survival (mo)Median follow-up (mo)
HEHE, hepatic epithelioid hemangioendothelioma; pNET, pancreatic neuroendocrine tumor; HCC, hepatocellular carcinoma; NA, not available
Digestive SystemHCC with portal vein tumor thrombusBlaise et al. (2021) [23]Clinical trial4416NA
Chai et al. (2017) [9]Case report1NANA
CholangiocarcinomaFranken et al. (2022) [10]Clinical trial1221NA
HEHENarayanan et al. (2024) [25]Clinical trial14NA15
pNETTasu et al. (2023) [26]Case report1NANA
Niu et al. (2017) [27]Case report1NANA
Urinary systemRenal cancerTrimmer et al. (2015) [28]Clinical trial20NA6
Wendler et al. (2016) [31]Clinical trial3NANA
Wagstaff et al. (2015) [30]Clinical trial10NANA
Endocrine systemThyroid cancerMeijerink et al. (2015) [34]Case report1NANA
Respiratory systemLung cancerRicke et al. (2015) [32]Clinical trial36NA12
Fanta et al. (2012) [33]Case report2NANA
Metastatic lymph nodesHead and neckXu et al. (2023) [37]Case report1NANA
Gastrointestinal tractKlein et al. (2017) [35]Case report1NANA
Pelvic cavityKwok et al. (2016) [36]Case report1NANA
RetroperitoneumJiang et al. (2019) [38]Case report3NANA

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Author (year of publication)Another therapyTumor typeNo. of patientsMedium age (y)Median tumour size (cm)Median overall survivalMedian progression free survivalAll complication rate
LAPC, locally advanced pancreatic cancer; HCC, hepatocellular carcinoma; PDAC, pancreatic ductal adenocarcinoma; ICC, intrahepatic cholangiocarcinoma; NA, not available.
In "Median overall survival" and "Median progression free survival", The data in this part refers to the 5-year survival rate/5-year progression-free survival rate or median survival time/median progression free survival.
Belfiore et al. (2015) [12]chemotherapyLAPC2069NANANA0
Månsson et al. (2016) [55]chemotherapyLAPC2465NA6.0%2.7%45.8%
Ma et al. (2020) [56]chemotherapyLAPC33634.119.8%8.3%9.1%
Veldhuisen et al. (2020) [57]chemotherapyLAPC30NA3.817.2%NANA
Dimitrios et al. (2021) [58]chemotherapyLAPC40653.824.2%10.3%NA
Lin et al. (2017) [59]immunotherapyStage III/IV PC32 (III 15; IV 17)III 55;
IV 59		III 5.01; IV 4.9213.2%9.3%NA
Yang et al. (2018) [60]immunotherapyHCC18574.823.2%15.1%NA
Pan et al. (2020) [61]immunotherapyLAPC92574.412.4%7.2%82.6%
Zhang et al. (2022) [62]immunotherapyHCC and ICC59NANAHCC: 8 mo; ICC: 8 moNAHCC: 13 mo; ICC: 9.5 mo
Martin et al. (2025) [63]immunotherapyPDAC30NANA32.5 mo18 mo23%
Ratnayake et al. (2021) [54]radiotherapyLAPC1503.5NANANA
Davis et al. (2023) [64]surgeryLAPC5NA3.221.6 mo10.6 moNA
Tasu et al. (2024) [51]surgeryLAPC1761NA31 mo21 mo58%
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