Pancreatic ductal adenocarcinoma (PDAC) remains one of the most challenging malignancies to treat, largely due to late diagnosis, limited surgical options, and profound resistance to systemic therapies, all of which contribute to a five-year survival rate of approximately 9%. The dense, hypoxic, and immunosuppressive tumor microenvironment (TME) of PDAC plays a critical role in immune evasion and therapeutic failure. As conventional immunotherapies have shown limited efficacy in PDAC, attention has shifted toward local interventions capable of remodeling the TME to enhance immune responsiveness. Endoscopic ultrasound (EUS)-guided ablative therapies have emerged as promising strategies to overcome these barriers. A range of modalities—including irreversible electroporation, microwave ablation, photodynamic therapy, and cryoablation—are under investigation. Among these, radiofrequency ablation (RFA) stands out as the most promising therapy as it not only induces direct tumor cytoreduction but also promotes antigen release, triggers immunogenic cell death, and may work synergistically with systemic therapies such as immune checkpoint inhibitors and adenosine pathway blockade. This review aims to explore the evolving role of endoscopic ablative therapies with a focus on RFA as a potential platform for immune activation in pancreatic cancer.
胰腺导管腺癌（PDAC）因其诊断晚、手术选择有限以及对系统治疗存在显著耐药性，五年生存率仅约9%，仍是治疗最具挑战性的恶性肿瘤之一。PDAC致密、缺氧且具免疫抑制性的肿瘤微环境在免疫逃逸和治疗失败中起着关键作用。由于传统免疫疗法在PDAC中疗效有限，研究重点已转向能够重塑肿瘤微环境以增强免疫应答的局部干预手段。内镜超声引导下的消融疗法已成为突破这些障碍的前瞻性策略。目前多种消融方式——包括不可逆电穿孔、微波消融、光动力疗法和冷冻消融——正处于研究阶段。其中射频消融展现出最显著的治疗潜力，它不仅能够直接实现肿瘤减灭，还能促进抗原释放、触发免疫原性细胞死亡，并可能与免疫检查点抑制剂、腺苷通路阻断等系统疗法产生协同效应。本文旨在探讨内镜消融疗法在胰腺癌治疗中不断演进的作用，重点关注射频消融作为免疫激活潜在平台的应用前景。
Endoscopic Immuno-Oncology: A New Frontier in Treatment of Pancreatic Cancer
肿瘤(癌症)患者之家