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- Title
Neoadjuvant therapy with intensity‐modulated radiotherapy combined with S‐1 for borderline‐resectable pancreatic cancer.
- Authors
Okamura, Yusuke; Nishitai, Ryuta; Sasaki, Naoya; Ito, Hitoshi; Sakamoto, Takashi; Itokawa, Yoshio; Kusumoto, Masanori; Nakai, Yoshitaka; Yamaoka, Toshihide; Manaka, Dai
- Abstract
Aim: We evaluated the efficacy of neoadjuvant chemotherapy with intensity‐modulated radiotherapy (NAC‐IMRT) in patients with borderline‐resectable pancreatic cancer (BRPC). Methods: BRPC patients were treated with IMRT (45 Gy/15fr) combined with two courses of S‐1 (40 mg/m2 bid) before surgery. Outcomes after NAC‐IMRT, surgery, and survival were then evaluated. This single‐center retrospective study assessed 26 consecutive patients. Results: Twenty‐six patients (BR‐PV: 7, BR‐A: 19) with a median age of 73 years were enrolled from 2016 to 2021. Ten (38%) patients were 75‐years‐old and above. Twenty‐three patients completed NAC‐IMRT treatment. The median reductions in tumor size and cancer antigen 19‐9 level were 13.6% and 69%, respectively. All 26 patients underwent resection within a median time of 71 days after NAC‐IMRT initiation. R0 resection was achieved in 24 patients (92%). The median overall survival (OS) was 28.0 months, and the 1‐ and 3‐year OS rates were 100% and 34%, respectively. The median progression‐free survival (PFS) was 12.5 months, and the 1‐ and 3‐year PFS rates were 50% and 32%, respectively. No significant differences were observed in OS between the patients under and over the age of 75 (29 vs. 20 months, p = 0.86). The 12 patients who completed NAC‐IMRT, resection, and subsequent adjuvant chemotherapy (AC) exhibited a 3‐year survival rate of 73%, which was significantly better than that of the patients who did not receive or complete AC (median OS, not reached vs. 19 months, p < 0.001). Conclusion: NAC‐IMRT showed outstanding clinical efficacy with acceptable tolerability in patients with BRPC, including geriatric patients.
- Subjects
INTENSITY modulated radiotherapy; NEOADJUVANT chemotherapy; PANCREATIC cancer; ADJUVANT chemotherapy; VOLUMETRIC-modulated arc therapy; RADIOTHERAPY; OVERALL survival
- Publication
Asia Pacific Journal of Clinical Oncology, 2024, Vol 20, Issue 4, p546
- ISSN
1743-7555
- Publication type
Article
- DOI
10.1111/ajco.14080