Pradermchai Kongkam, Kasenee Tiankanon, Dong Wan Seo, Thanawat Luangsukrerk, Virote Sriuranpong, Chonnipa Nantavithya, Trirat Jantarattana, Arlyn Cañones, Stephen J Kerr, Kittithat Tantitanawat, Phonthep Angsuwatcharakon, Wiriyaporn Ridtitid, Pinit Kullavanijaya, Rungsun Rerknimitr
{"title":"<i>E</i>US-guided <i>r</i>adiofrequency <i>a</i>blation plus chemotherapy <i>versus</i> chemotherapy alone for <i>p</i>ancreatic cancer (ERAP): An observational open-label pilot study.","authors":"Pradermchai Kongkam, Kasenee Tiankanon, Dong Wan Seo, Thanawat Luangsukrerk, Virote Sriuranpong, Chonnipa Nantavithya, Trirat Jantarattana, Arlyn Cañones, Stephen J Kerr, Kittithat Tantitanawat, Phonthep Angsuwatcharakon, Wiriyaporn Ridtitid, Pinit Kullavanijaya, Rungsun Rerknimitr","doi":"10.1097/eus.0000000000000003","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>No study has compared EUS-guided radiofrequency ablation (EUS-RFA) plus systemic chemotherapy (CMT) with CMT alone for unresectable pancreatic ductal adenocarcinoma.</p><p><strong>Methods: </strong>This study compared the results of treatment in patients receiving EUS-RFA plus concomitant CMT (group A; <i>n</i> = 14) with those receiving CMT (group B; <i>n</i> = 14) as a pilot study.</p><p><strong>Results: </strong>From July 2017 to August 2018, 4 and 2 patients from groups A and B, respectively, withdrew from the study because of progression of the disease. In total, 10 and 12 patients from groups A and B, respectively, completed the study. All 30 EUS-RFA procedures were successful. Mean maximal tumor diameter before treatment of group A (<i>n</i> = 10) <i>versus</i> B (<i>n</i> = 12) was 62.2 ± 21.0 <i>versus</i> 50.5 ± 22.0 mm, respectively (<i>P</i> = not significant). After treatment, no statistically significant difference in mean maximal tumor diameter was found between both groups. However, in group B, mean maximal tumor diameter was significantly increased from 50.5 ± 22.0 to 56.3 ± 18.7 mm, respectively (<i>P</i> = 0.017). Tumor necrosis occurred in group A <i>versus</i> B at 10 of 10 (100%) <i>versus</i> 6 of 12 (50%) patients, respectively (<i>P</i> = 0.014). After treatment, group A patients could reduce the mean narcotic pain drug dosage at 26.5 mg of morphine equivalent per day (from 63.6 to 37.1 mg, <i>P</i> = 0.022), whereas group B patients could not reduce the dosage of pain-controlled medication. No statistically significant difference in 6-month mortality rate was found. In group A, 1 procedure-related nonsevere adverse event (<i>n</i> = 1 of 30 [3.3%]) occurred in 1 patient (<i>n</i> = 1 of 14 [7.1%]).</p><p><strong>Conclusions: </strong>In this study, the mean tumor diameter of group B was significantly increased after the treatment. Group A had a significantly higher rate of necrosis of tumor and required less narcotic.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"12 5","pages":"402-408"},"PeriodicalIF":4.4000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631592/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endoscopic Ultrasound","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/eus.0000000000000003","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/23 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: No study has compared EUS-guided radiofrequency ablation (EUS-RFA) plus systemic chemotherapy (CMT) with CMT alone for unresectable pancreatic ductal adenocarcinoma.
Methods: This study compared the results of treatment in patients receiving EUS-RFA plus concomitant CMT (group A; n = 14) with those receiving CMT (group B; n = 14) as a pilot study.
Results: From July 2017 to August 2018, 4 and 2 patients from groups A and B, respectively, withdrew from the study because of progression of the disease. In total, 10 and 12 patients from groups A and B, respectively, completed the study. All 30 EUS-RFA procedures were successful. Mean maximal tumor diameter before treatment of group A (n = 10) versus B (n = 12) was 62.2 ± 21.0 versus 50.5 ± 22.0 mm, respectively (P = not significant). After treatment, no statistically significant difference in mean maximal tumor diameter was found between both groups. However, in group B, mean maximal tumor diameter was significantly increased from 50.5 ± 22.0 to 56.3 ± 18.7 mm, respectively (P = 0.017). Tumor necrosis occurred in group A versus B at 10 of 10 (100%) versus 6 of 12 (50%) patients, respectively (P = 0.014). After treatment, group A patients could reduce the mean narcotic pain drug dosage at 26.5 mg of morphine equivalent per day (from 63.6 to 37.1 mg, P = 0.022), whereas group B patients could not reduce the dosage of pain-controlled medication. No statistically significant difference in 6-month mortality rate was found. In group A, 1 procedure-related nonsevere adverse event (n = 1 of 30 [3.3%]) occurred in 1 patient (n = 1 of 14 [7.1%]).
Conclusions: In this study, the mean tumor diameter of group B was significantly increased after the treatment. Group A had a significantly higher rate of necrosis of tumor and required less narcotic.
期刊介绍:
Endoscopic Ultrasound, a publication of Euro-EUS Scientific Committee, Asia-Pacific EUS Task Force and Latin American Chapter of EUS, is a peer-reviewed online journal with Quarterly print on demand compilation of issues published. The journal’s full text is available online at http://www.eusjournal.com. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal does not charge for submission, processing or publication of manuscripts and even for color reproduction of photographs.