Impact of neoadjuvant intensity-modulated radiation therapy on borderline resectable pancreatic cancer with arterial abutment; a prospective, open-label, phase II study in a single institution.
Impact of neoadjuvant intensity-modulated radiation therapy on borderline resectable pancreatic cancer with arterial abutment; a prospective, open-label, phase II study in a single institution.
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新辅助调强放疗对动脉支抗交界性可切除胰腺癌的影响：一项在单一机构进行的前瞻性、开放标签、II期研究。
DOI：
10.1186/s12885-022-09244-6
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发表时间：
2022-01-29
期刊：
影响因子：
3.8
通讯作者：
Hatano E
中科院分区：
文献类型：
--
作者：
Masui T;Nagai K;Anazawa T;Sato A;Uchida Y;Nakano K;Yogo A;Kaneda A;Nakamura N;Yoshimura M;Mizowaki T;Uza N;Fukuda A;Matsumoto S;Kanai M;Isoda H;Mizumoto M;Seo S;Hata K;Taura K;Kawaguchi Y;Takaori K;Uemoto S;Hatano E
边缘可切除胰腺癌（BRPC）是一类解剖学上广泛扩散的胰腺癌，并且根治性切除术在前期手术中并不常见。调强放射治疗（IMRT）是一种放射治疗形式，它向肿瘤提供精确的放射，同时最大限度地减少对周围正常组织的剂量。在这里，我们进行了一项2期研究，以评估使用调强放疗（NACIMRT）的新辅助放化疗对动脉基台（BRPC-A）BRPC患者的治愈性和疗效。本研究共入组了49例BRPC-A患者，并于2013年6月至2021年3月期间根据研究方案在我院接受治疗。主要终点是显微镜下切缘阴性切除率（R 0），我们随后分析了NACIMRT患者的安全性、治疗的组织学效果以及生存率。29例（59.2%）患者在NACIMRT后接受胰腺切除术。手术切除患者的R 0率为93.1%，整个队列的R 0率为55.1%。未发生死亡。局部疗效按Evans分级，1级3.4%，2a级31.0%，2b级48.3%，3级3.4%，4级3.4%。中位无病生存期为15.5个月。整个队列的中位总生存期为35.1个月。NACIMRT前确定的唯一独立预后因素是NACIMRT前血清碳水化合物抗原19-9（CA 19 -9）> 400 U/ml。BRPC-A患者的NACIMRT显示了较好的结果，无明显的手术并发症。NACIMRT有助于良好的局部肿瘤控制，但高的初始血清CA 19 -9意味着即使在新辅助治疗后预后不良。UMIN-CTR临床试验：https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi? recptno= R 000011776注册号：UMIN 000010113。首次注册日期：2013年3月1日，
Borderline resectable pancreatic cancer (BRPC) is a category of pancreatic cancer that is anatomically widely spread, and curative resection is uncommon with upfront surgery. Intensity-modulated radiation therapy (IMRT) is a form of radiation therapy that delivers precise radiation to a tumor while minimizing the dose to surrounding normal tissues. Here, we conducted a phase 2 study to estimate the curability and efficacy of neoadjuvant chemoradiotherapy using IMRT (NACIMRT) for patients with BRPC with arterial abutment (BRPC-A). A total of 49 BRPC-A patients were enrolled in this study and were treated at our hospital according to the study protocol between June 2013 and March 2021. The primary endpoint was microscopically margin-negative resection (R0) rates and we subsequently analyzed safety, histological effect of the treatment as well as survivals among patients with NACIMRT. Twenty-nine patients (59.2%) received pancreatectomy after NACIMRT. The R0 rate in resection patients was 93.1% and that in the whole cohort was 55.1%. No mortality was encountered. Local therapeutic effects as assessed by Evans classification showed good therapeutic effect (Grade 1, 3.4%; Grade 2a, 31.0%; Grade 2b, 48.3%; Grade 3, 3.4%; Grade 4, 3.4%). Median disease-free survival was 15.5 months. Median overall survival in the whole cohort was 35.1 months. The only independent prognostic pre-NACIMRT factor identified was serum carbohydrate antigen 19–9 (CA19-9) > 400 U/ml before NACIMRT. NACIMRT showed preferable outcome without significant operative morbidity for BRPC-A patients. NACIMRT contributes to good local tumor control, but a high initial serum CA19-9 implies poor prognosis even after neoadjuvant treatment. UMIN-CTR Clinical Trial: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000011776 Registration number: UMIN000010113. Date of first registration: 01/03/2013,
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DOI：
10.1186/s13014-020-01712-2
发表时间：
2020-11-13
期刊：
Radiation oncology (London, England)
影响因子：
--
作者：
Iwai T;Yoshimura M;Ashida R;Goto Y;Kishi T;Itasaka S;Shibuya K;Kanai M;Masui T;Fukuda A;Isoda H;Hiraoka M;Mizowaki T
通讯作者：
Mizowaki T
影响因子：
3
作者：
Nagakawa, Yuichi;Hosokawa, Yuichi;Tsuchida, Akihiko
通讯作者：
Tsuchida, Akihiko
影响因子：
3.8
作者：
Liu, Fang;Luo, Ting;Liu, Lei
通讯作者：
Liu, Lei
影响因子：
5.7
作者：
Mori, Shinichiro;Hara, Ryusuke;Kamada, Tadashi
通讯作者：
Kamada, Tadashi
影响因子：
254.7
作者：
Siegel, Rebecca L.;Miller, Kimberly D.;Jemal, Ahmedin
通讯作者：
Jemal, Ahmedin