國家衛生研究院 NHRI:Item 3990099045/14369
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    題名: Improved survival with induction chemotherapy and conversion surgery in locally advanced unresectable pancreatic cancer: A single institution experience
    作者: Su, YY;Ting, YL;Wang, CJ;Chao, YJ;Liao, TK;Su, PJ;Chiang, NJ;Liao, IC;Yu, YT;Liu, YS;Tsai, HM;Li, YJ;Huang, CJ;Liu, IT;Tsai, HJ;Yen, CJ;Shan, YS;Chen, LT
    貢獻者: National Institute of Cancer Research
    摘要: Both efficacy and tolerability are critical issues in choosing neoadjuvant chemotherapy in patients with unresectable locally advanced pancreatic cancer (LAPC). The optimal regimen and the impact of conversion surgery on patient survival remains insufficiently reported in Asain population. Therefore, we conducted a retrospective study aiming to evaluate the resection rate after different induction chemotherapy regimen and its impact toward survival. All patients with pancreatic cancer treated in our institute from 2013 to 2020, a total of 730 patients, were reviewed and 131 patients with LAPC were identified. For cohort homogeneity, 14 patients receiving induction concurrent chemoradiotherapy initially were excluded and 117 patients receiving induction chemotherapy were included in the study. Most patients (90 of 117, 77%) received triplet induction chemotherapy, including the combination of S1, leucovorin, oxaliplatin and gemcitabine (SLOG) in 48, modified FOLFIRINOX in 21 and the combination of gemcitabine, oxaliplatin, fluorouracil and leucovorin (GOFL) in 21. The tumor response rate (19%-33%), the surgical exploration rate (38%-52%) and the mOS (15.4-23.0 months) were not significantly different among the three triplets. Both GOFL and SLOG regimen had comparable efficacy and less neutropenia as compared to mFOLFIRINOX. Conversion surgery was performed in 34 of 117 (29%) patients after induction chemotherapy. The median overall survival (mOS) in patients with and without conversion surgery were 29.1 and 14.1 months, respectively (P<0.0001). Radiological response alone was not a reliable indicator of successful conversion surgery. Patients who underwent conversion surgery had significantly better survival and thus highlighted the importance of surgical exploration in all patients who did not have progressive disease after induction chemotherapy.
    日期: 2022-05-15
    關聯: American Journal of Cancer Research. 2022 May 15;12(5):2189-2202.
    Link to: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9185606/
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=2156-6976&DestApp=IC2JCR
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