Gemcitabine based neoadjuvant chemoradiotherapy therapy in patients with borderline resectable pancreatic cancer
Gemcitabine based neoadjuvant chemoradiotherapy therapy in patients with borderline resectable pancreatic cancer
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DOI：
10.1016/j.pan.2013.07.064
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发表时间：
2013-09-01
期刊：
影响因子：
3.6
通讯作者：
Park, Jeong Youp
中科院分区：
文献类型：
--
作者：
Cho, In Rae;Chung, Moon Jae;Park, Jeong Youp
背景资料：手术切除是胰腺癌的唯一治愈性治疗方法，但由于手术的复杂性和肿瘤的晚期性质，边缘性可切除胰腺癌（BRPC）的手术结局通常较差。本研究的目的是评估是否新辅助同步放化疗（CCRT）在BRPC患者可以改善手术outcome.Methods：基线特征和治疗结果进行了回顾性比较，BRPC手术（CCRT（+）组）和没有新辅助治疗（CCRT（-）组）的患者。治疗结果包括总生存率、无复发生存率和围手术期并发症。结果：CCRT（+）组30例，CCRT（-）组21例。CCRT前的基线特征没有差异，但切除后的病理检查显示CCRT（+）组肿瘤大小减小，神经血管浸润率较低。CCRT（+）组的总体中位生存时间为45.0个月，CCRT（-）组为23.5个月（p = 0.045）。与CCRT（-）组相比，CCRT（+）组的复发率较低（50.0% vs. 81.0%; p = 0.024），中位无病生存期较长（21.0个月vs. 10.6个月; p = 0.004）。围手术期并发症发生率两组之间没有差异。结论：新辅助放化疗结合手术切除的BRPC患者比单纯手术治疗效果更好。需要进一步更大规模的前瞻性临床试验，明确定义入组标准和治疗计划。版权所有（C）2013，IAP和EPC。由爱思唯尔印度出版，里德爱思唯尔印度私人有限公司的一个部门。保留所有权利。
Background: Surgical resection is the only curative treatment for pancreatic cancer, but surgical outcomes for borderline resectable pancreatic cancer (BRPC) are generally poor because of the complexity of the surgery and the advanced nature of the tumor. The aim of this study was to evaluate whether neoadjuvant concurrent chemoradiation therapy (CCRT) in BRPC patients could improve surgical outcome.Methods: Baseline characteristics and treatment outcomes for patients who underwent surgery for BRPC with (CCRT (+) group) and without neoadjuvant treatment (CCRT (-) group) were retrospectively compared. Treatment outcomes measured included overall survival, recurrence-free survival, and perioperative complications.Results: A total of 30 patients were included in the CCRT (+) group and 21 patients in the CCRT (-) group. Baseline characteristics were not different before CCRT, but pathological examination after resection revealed reduced tumor size and a lower neurovascular invasion rate in the CCRT (+) group. Overall median survival time was 45.0 months in the CCRT (+) group and 23.5 months in the CCRT (-) group (p = 0.045). The CCRT (+) group had a lower recurrence rate (50.0% vs. 81.0%; p = 0.024) and a longer median disease-free survival period (21.0 months vs. 10.6 months; p = 0.004) than the CCRT (-) group. Perioperative complication rates were not different between the two groups.Conclusions: Neoadjuvant chemoradiation therapy combined with surgical resection yielded better treatment outcomes in patients with BRPC compared with surgery alone. Further larger prospective clinical trials with well defined enrollment criteria and treatment plan are needed. Copyright (C) 2013, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.