Analysis of the Safety and Efficacy of Cryoablation in Patients with Locally Advanced Pancreatic Cancer.

IF 3.8 2区 医学 Q2 ONCOLOGY
Shutong Shao, Li Wang, Feng Tan, Shengzhong Hou, Kang Xue, Xing Huang, Dan Cao, Junjie Xiong, Bole Tian
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Abstract

Background: Cryoablation is emerging as a potential treatment option for locally advanced pancreatic cancer (LAPC). The aim of this study was to retrospectively evaluate the safety and efficacy of cryoablation in patients with LAPC. The study has been prospectively registered in the Chinese Clinical Trial Registry (ID: ChiCTR2300068376).

Patients and methods: Adult patients with LAPC were stratified based on the treatment modality (cryoablation versus systemic therapy). The cryoablation was performed using a single cryoprobe under ultrasound guidance. The Kaplan-Meier method was utilized to evaluate and compare overall survival (OS) among the groups. Cox proportional hazards regression analysis was employed to identify independent predictors of overall survival.

Results: Of 186 enrolled patients with LAPC between August 2022 and December 2024, 142 were in the cryoablation group and 44 in the systemic therapy alone group. The median OS was 17.8 months with systemic therapy alone and 18.7 months with cryoablation alone. Combined cryoablation and systemic therapy yielded a median OS of 22.1 months. Among patients receiving cryoablation combined with chemotherapy median OS was 19.8 months, and for combination systemic therapy group (chemotherapy + immunotherapy ± targeted therapy), it was 25.4 months. Multivariate analysis identified age, tumor location, treatment type, and jaundice as independent OS predictors. Additionally, nearly all patients experienced marked pain relief after cryoablation treatment.

Conclusions: When combined with systemic therapy, cryoablation has a more significant survival advantage than systemic therapy alone. However, due to the heterogeneity of the cohort and potential immortal time bias, these survival outcomes should be interpreted with caution. Additionally, cryoablation offers effective benefits for relieving cancer pain and preserving functional quality of life in patients with LAPC.

局部晚期胰腺癌冷冻消融的安全性和有效性分析。
背景:冷冻消融正在成为局部晚期胰腺癌(LAPC)的潜在治疗选择。本研究的目的是回顾性评价冷冻消融治疗LAPC患者的安全性和有效性。该研究已在中国临床试验注册中心(ID: ChiCTR2300068376)前瞻性注册。患者和方法:根据治疗方式(冷冻消融与全身治疗)对成年LAPC患者进行分层。在超声引导下使用单冷冻探针进行冷冻消融。采用Kaplan-Meier法评价和比较各组总生存期(OS)。采用Cox比例风险回归分析确定总生存率的独立预测因子。结果:在2022年8月至2024年12月期间,186例入选的LAPC患者中,142例在冷冻消融组,44例在单独全身治疗组。单独全身治疗的中位OS为17.8个月,单独冷冻消融的中位OS为18.7个月。联合冷冻消融和全身治疗的中位OS为22.1个月。冷冻消融联合化疗组中位OS为19.8个月,联合全身治疗组(化疗+免疫治疗±靶向治疗)中位OS为25.4个月。多变量分析发现年龄、肿瘤位置、治疗类型和黄疸是独立的OS预测因子。此外,几乎所有患者在冷冻消融治疗后疼痛明显缓解。结论:当联合全身治疗时,冷冻消融比单独全身治疗具有更显著的生存优势。然而,由于队列的异质性和潜在的不朽时间偏差,这些生存结果应谨慎解释。此外,冷冻消融术在缓解癌症疼痛和保持LAPC患者的功能生活质量方面提供了有效的益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.90
自引率
10.80%
发文量
1698
审稿时长
2.8 months
期刊介绍: The Annals of Surgical Oncology is the official journal of The Society of Surgical Oncology and is published for the Society by Springer. The Annals publishes original and educational manuscripts about oncology for surgeons from all specialities in academic and community settings.
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