Gemcitabine based neoadjuvant chemoradiotherapy therapy in patients with borderline resectable pancreatic cancer

I. Rae Cho, Moon Jae Chung, Seungmin Bang, Seung Woo Park, Jae Bock Chung, S. Young Song, Jinsil Seong, H. Kyoung Hwang, Chang Moo Kang, Woo Jung Lee, Jeong Youp Park

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Abstract

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 CCRTgroup. Overall median survival time was 45.0 months in the CCRTgroup 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; p0.004) 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.

Original languageEnglish
Pages (from-to)539-543
Number of pages5
JournalPancreatology
Volume13
Issue number5
DOIs
Publication statusPublished - 2013 Jan 1

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Gastroenterology

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    Cho, I. R., Chung, M. J., Bang, S., Park, S. W., Chung, J. B., Song, S. Y., Seong, J., Hwang, H. K., Kang, C. M., Lee, W. J., & Park, J. Y. (2013). Gemcitabine based neoadjuvant chemoradiotherapy therapy in patients with borderline resectable pancreatic cancer. Pancreatology, 13(5), 539-543. https://doi.org/10.1016/j.pan.2013.07.064