Neoadjuvant Chemotherapy With Chemoradiotherapy for Patients With Borderline Resectable or Locally Advanced Pancreatic Ductal Adenocarcinoma—Retrospective Review From a Tertiary Care Hospital

IF 1.6 4区医学 Q4 ONCOLOGY

Asia-Pacific journal of clinical oncology Pub Date : 2025-03-20 DOI:10.1111/ajco.14166

Avtaj Nerwal, Desmond Yip, Sivakumar Gananadha, Amy Shorthouse, Belinda Lee, Ankit Jain

{"title":"Neoadjuvant Chemotherapy With Chemoradiotherapy for Patients With Borderline Resectable or Locally Advanced Pancreatic Ductal Adenocarcinoma—Retrospective Review From a Tertiary Care Hospital","authors":"Avtaj Nerwal, Desmond Yip, Sivakumar Gananadha, Amy Shorthouse, Belinda Lee, Ankit Jain","doi":"10.1111/ajco.14166","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>Patients diagnosed with borderline resectable pancreatic cancer (BRPC) or locally advanced pancreatic cancer (LAPC) have historically worse survival rates compared to those with resectable pancreatic cancer. The study aimed to assess the feasibility and efficacy of neoadjuvant chemotherapy and chemoradiotherapy in BRPC/LAPC. Additionally, we evaluated the R0 resection rates for patients who progressed to surgery.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This retrospective study included patients diagnosed with BRPC/LAPC between January 2019 and December 2023 at The Canberra Hospital (TCH), a tertiary care setting. A total of 115 patients were screened, of whom 37 were eligible for inclusion. Demographic data, CA19-9 levels, treatment regimens, surgical outcomes, resection rates, disease-free survival (DFS), and overall survival were analysed.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 20 (54%) patients (15 FOLFIRINOX and 5 gemcitabine/nab-paclitaxel) completed their planned chemotherapy, and 17 (46%) of these patients had chemoradiotherapy, majority receiving 45–50 Gy of conventional radiation with capecitabine. Tumor marker Ca19-9 normalized after chemotherapy in seven patients (19%). In total, 23 patients (62.2%) progressed to surgery. The median DFS for all patients was 12.7 months (95% CI 5.5–15.9), and the median OS was 21 months (95% CI 13.7–44.9).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>This study suggests that neoadjuvant treatment is feasible for BRPC/LAPC, allowing patients to undergo surgery and achieve R0 resection. However, further randomized controlled trials with larger cohorts are needed to validate these findings and refine treatment protocols.</p>\n </section>\n </div>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":"21 4","pages":"392-398"},"PeriodicalIF":1.6000,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajco.14166","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia-Pacific journal of clinical oncology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ajco.14166","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Aim

Patients diagnosed with borderline resectable pancreatic cancer (BRPC) or locally advanced pancreatic cancer (LAPC) have historically worse survival rates compared to those with resectable pancreatic cancer. The study aimed to assess the feasibility and efficacy of neoadjuvant chemotherapy and chemoradiotherapy in BRPC/LAPC. Additionally, we evaluated the R0 resection rates for patients who progressed to surgery.

Methods

This retrospective study included patients diagnosed with BRPC/LAPC between January 2019 and December 2023 at The Canberra Hospital (TCH), a tertiary care setting. A total of 115 patients were screened, of whom 37 were eligible for inclusion. Demographic data, CA19-9 levels, treatment regimens, surgical outcomes, resection rates, disease-free survival (DFS), and overall survival were analysed.

Results

A total of 20 (54%) patients (15 FOLFIRINOX and 5 gemcitabine/nab-paclitaxel) completed their planned chemotherapy, and 17 (46%) of these patients had chemoradiotherapy, majority receiving 45–50 Gy of conventional radiation with capecitabine. Tumor marker Ca19-9 normalized after chemotherapy in seven patients (19%). In total, 23 patients (62.2%) progressed to surgery. The median DFS for all patients was 12.7 months (95% CI 5.5–15.9), and the median OS was 21 months (95% CI 13.7–44.9).

Conclusion

This study suggests that neoadjuvant treatment is feasible for BRPC/LAPC, allowing patients to undergo surgery and achieve R0 resection. However, further randomized controlled trials with larger cohorts are needed to validate these findings and refine treatment protocols.

Abstract Image

查看原文本刊更多论文

新辅助化疗联合放化疗治疗边缘性可切除或局部晚期胰腺导管腺癌——来自三级医院的回顾性回顾

目的：诊断为交界性可切除胰腺癌（BRPC）或局部晚期胰腺癌（LAPC）的患者与可切除胰腺癌患者相比，历史上的生存率更差。本研究旨在评估新辅助化疗和放化疗治疗BRPC/LAPC的可行性和疗效。此外，我们评估了进展到手术的患者的R0切除率。方法：本回顾性研究纳入了2019年1月至2023年12月在三级医疗机构堪培拉医院（TCH）诊断为BRPC/LAPC的患者。共筛选了115例患者，其中37例符合纳入条件。分析了人口统计学数据、CA19-9水平、治疗方案、手术结果、切除率、无病生存期（DFS）和总生存期。结果：共有20例（54%）患者（15例FOLFIRINOX和5例吉西他滨/nab-紫杉醇）完成了计划的化疗，其中17例（46%）患者进行了放化疗，大多数接受卡培他滨45-50 Gy的常规放疗。7例（19%）患者化疗后肿瘤标志物Ca19-9恢复正常。共有23例患者（62.2%）进展到手术。所有患者的中位DFS为12.7个月（95% CI 5.5-15.9），中位OS为21个月（95% CI 13.7-44.9）。结论：本研究提示BRPC/LAPC采用新辅助治疗是可行的，可使患者接受手术治疗并实现R0切除。然而，需要更多的随机对照试验来验证这些发现并完善治疗方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Asia-Pacific journal of clinical oncology 医学-肿瘤学

CiteScore

3.40

自引率

0.00%

发文量

175

审稿时长

6-12 weeks

期刊介绍： Asia–Pacific Journal of Clinical Oncology is a multidisciplinary journal of oncology that aims to be a forum for facilitating collaboration and exchanging information on what is happening in different countries of the Asia–Pacific region in relation to cancer treatment and care. The Journal is ideally positioned to receive publications that deal with diversity in cancer behavior, management and outcome related to ethnic, cultural, economic and other differences between populations. In addition to original articles, the Journal publishes reviews, editorials, letters to the Editor and short communications. Case reports are generally not considered for publication, only exceptional papers in which Editors find extraordinary oncological value may be considered for review. The Journal encourages clinical studies, particularly prospectively designed clinical trials.