Detailed Abstract
[Poster - Pancreas Disease/Surgery]
[P105] Clinical significance of neoadjuvant chemoradiotherapy for borderline resectable pancreatic cancer
Yasuhiro YABUSHITA, Ryusei MATSUYAMA, Nobuhiro TSUCHIYA, Takashi MURAKAMI, Yu SAWADA, Ryutaro MORI, Takafumi KUMAMOTO, Itaru ENDO
Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Japan, Japan
Introduction : Our therapeutic strategy for borderline resectable pancreatic cancer (BRPC) is neoadjuvant chemoradiotherapy (NACRT) using gemcitabine plus S-1 (GS) .The aim of this study is to clarify the effectiveness and safety of NACRT for BRPC
Methods : From 2009 to 2015, 128 patients with BRPC were treated with NACRT. The GS regimen comprised intravenous administration of 1,000 mg/m2 GEM on days 8 and 15, and daily oral administration of 60 mg/m2 S-1 on days 1–14. After two courses of GS therapy, radiation therapy (30 Gy) combined with systemic oral S-1 (60 mg/m2) were performed. Preoperative treatment and perioperative factors, and long-term outcome were evaluated.
Results : 118 of 128 (92.2%) patients achieved SD or more effect. 97 (75.8%) patients were resected. Resection procedures included PD in 83 cases (86%), DP in 13 cases (13%) and TP in one case (1%). Combined resection of major vessels was performed in 74 cases (76%). R0 resection was achieved in 92 cases (95%). The morbidity rate was 18%, and there is no mortality. Histological responses was classified according to Evans criteria as Grade 1/2a in 59 patients (61%), grade 2b in 30 patients (31%) and grade 3 in 7 patients (7%). Adjuvant chemotherapy was performed in 73 patients (75%). Median survival time of resected cases was 24.4 months and 5-year survival was 30.3%.
Conclusions : Neoadjuvant therapy is safe and feasible in BRPC. This therapeutic strategy achieved high rate of R0 resection and might contribute to improve overall survival in BRPC.
Methods : From 2009 to 2015, 128 patients with BRPC were treated with NACRT. The GS regimen comprised intravenous administration of 1,000 mg/m2 GEM on days 8 and 15, and daily oral administration of 60 mg/m2 S-1 on days 1–14. After two courses of GS therapy, radiation therapy (30 Gy) combined with systemic oral S-1 (60 mg/m2) were performed. Preoperative treatment and perioperative factors, and long-term outcome were evaluated.
Results : 118 of 128 (92.2%) patients achieved SD or more effect. 97 (75.8%) patients were resected. Resection procedures included PD in 83 cases (86%), DP in 13 cases (13%) and TP in one case (1%). Combined resection of major vessels was performed in 74 cases (76%). R0 resection was achieved in 92 cases (95%). The morbidity rate was 18%, and there is no mortality. Histological responses was classified according to Evans criteria as Grade 1/2a in 59 patients (61%), grade 2b in 30 patients (31%) and grade 3 in 7 patients (7%). Adjuvant chemotherapy was performed in 73 patients (75%). Median survival time of resected cases was 24.4 months and 5-year survival was 30.3%.
Conclusions : Neoadjuvant therapy is safe and feasible in BRPC. This therapeutic strategy achieved high rate of R0 resection and might contribute to improve overall survival in BRPC.
SESSION
Poster
Poster / Exhibition Hall and Lobby(2F) 1/1/1970 9:00 AM - 9:00 AM