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タイトル: Impact of neoadjuvant intensity-modulated radiation therapy on borderline resectable pancreatic cancer with arterial abutment; a prospective, open-label, phase II study in a single institution
著者: Masui, Toshihiko
Nagai, Kazuyuki  kyouindb  KAKEN_id
Anazawa, Takayuki  kyouindb  KAKEN_id
Sato, Asahi
Uchida, Yuichiro
Nakano, Kenzo
Yogo, Akitada
Kaneda, Akihiro
Nakamura, Naoto
Yoshimura, Michio  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0001-6665-2245 (unconfirmed)
Mizowaki, Takashi  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-8135-8746 (unconfirmed)
Uza, Norimitsu  kyouindb  KAKEN_id
Fukuda, Akihisa  kyouindb  KAKEN_id
Matsumoto, Shigemi  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0001-6453-7489 (unconfirmed)
Kanai, Masashi  KAKEN_id
Isoda, Hiroyoshi  kyouindb  KAKEN_id
Mizumoto, Masaki
Seo, Satoru
Hata, Koichiro  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-3609-6396 (unconfirmed)
Taura, Kojiro
Kawaguchi, Yoshiya
Takaori, Kyoichi
Uemoto, Shinji
Hatano, Etsuro
著者名の別形: 増井, 俊彦
長井, 和之
穴澤, 貴行
佐藤, 朝日
内田, 雄一郎
仲野, 健三
余語, 覚匡
金田, 明大
中村, 直人
吉村, 通央
溝脇, 尚志
宇座, 徳光
福田, 晃久
松本, 繁巳
金井, 雅史
磯田, 裕義
水本, 雅己
瀬尾, 智
秦, 浩一郎
田浦, 康二朗
川口, 義弥
髙折, 恭一
上本, 伸二
波多野, 悦朗
キーワード: Neoadjuvant therapy
Pancreatic cancer
Intensity-Modulated Radiotherapy
Surgery
発行日: 2022
出版者: Springer Nature
BMC
誌名: BMC Cancer
巻: 22
論文番号: 119
抄録: BACKGROUND: Borderline resectable pancreatic cancer (BRPC) is a category of pancreatic cancer that is anatomically widely spread, and curative resection is uncommon with upfront surgery. Intensity-modulated radiation therapy (IMRT) is a form of radiation therapy that delivers precise radiation to a tumor while minimizing the dose to surrounding normal tissues. Here, we conducted a phase 2 study to estimate the curability and efficacy of neoadjuvant chemoradiotherapy using IMRT (NACIMRT) for patients with BRPC with arterial abutment (BRPC-A). METHODS: A total of 49 BRPC-A patients were enrolled in this study and were treated at our hospital according to the study protocol between June 2013 and March 2021. The primary endpoint was microscopically margin-negative resection (R0) rates and we subsequently analyzed safety, histological effect of the treatment as well as survivals among patients with NACIMRT. RESULTS: Twenty-nine patients (59.2%) received pancreatectomy after NACIMRT. The R0 rate in resection patients was 93.1% and that in the whole cohort was 55.1%. No mortality was encountered. Local therapeutic effects as assessed by Evans classification showed good therapeutic effect (Grade 1, 3.4%; Grade 2a, 31.0%; Grade 2b, 48.3%; Grade 3, 3.4%; Grade 4, 3.4%). Median disease-free survival was 15.5 months. Median overall survival in the whole cohort was 35.1 months. The only independent prognostic pre-NACIMRT factor identified was serum carbohydrate antigen 19-9 (CA19-9) > 400 U/ml before NACIMRT. CONCLUSIONS: NACIMRT showed preferable outcome without significant operative morbidity for BRPC-A patients. NACIMRT contributes to good local tumor control, but a high initial serum CA19-9 implies poor prognosis even after neoadjuvant treatment. TRIAL REGISTRATION: UMIN-CTR Clinical Trial: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000011776 Registration number: UMIN000010113. Date of first registration: 01/03/2013.
著作権等: © The Author(s) 2022
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
URI: http://hdl.handle.net/2433/277697
DOI(出版社版): 10.1186/s12885-022-09244-6
PubMed ID: 35093003
出現コレクション:学術雑誌掲載論文等

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