Journal article
Neoadjuvant chemoradiotherapy for locally advanced pancreas cancer rarely leads to radiological evidence of tumour regression
HPB (Oxford, England), Vol.15(9), pp.661-667
09/2013
DOI: 10.1111/hpb.12015
PMID: 23458352
Abstract
Background: Neo-adjuvant chemo-radiotherapy has been proposed to improve resectability of locally-advanced pancreatic cancer (LAPC). However, the ability of neo-adjuvant therapy to induce radiological tumour regression has not been reported.
Methods: Pre- and post-treatment computed tomography (CT) scans of patients undergoing neoadjuvant chemo-radiotherapy for LAPC were reviewed. LAPC was sub-classified into borderline resectable disease [<= 180 degrees involvement of the superior mesenteric artery (SMA); short-segment encasement/abutment of the common hepatic artery; or tumour-associated deformity, abutment or short-segment occlusion of the superior mesenteric vein (SMV)/portal vein (PV) that was amenable to vascular resection and reconstruction] and locally advanced un-resectable pancreatic cancer (vascular involvement more than that described for borderline resectable pancreatic cancer). The radiological response and surgical resection rates were assessed.
Results: Sixteen patients received neo-adjuvant therapy for LAPC during 2005-2008. Regression of major vascular involvement, i.e. un-encasement or regression of abutment of any involved vessels was not observed in any patient. Pre-and post-treatment tumour densities were not statistically different. Fifty per cent of patients with borderline resectable disease and none of the patients with locally advanced un-resectable pancreatic cancer eventually underwent surgical resection.
Conclusion: Neo-adjuvant treatment does not induce radiological tumour regression of LAPC with major vascular involvement. Patient selection for neo-adjuvant trial enrolment should remain focused on borderline disease which may have a potential for surgical resection.
Details
- Title: Subtitle
- Neoadjuvant chemoradiotherapy for locally advanced pancreas cancer rarely leads to radiological evidence of tumour regression
- Creators
- Vikas Dudeja - University of MinnesotaEdward W. Greeno - University of MinnesotaSidney P. Walker - University of MinnesotaEric H. Jensen - University of Minnesota
- Resource Type
- Journal article
- Publication Details
- HPB (Oxford, England), Vol.15(9), pp.661-667
- DOI
- 10.1111/hpb.12015
- PMID
- 23458352
- NLM abbreviation
- HPB (Oxford)
- ISSN
- 1365-182X
- eISSN
- 1477-2574
- Publisher
- Elsevier
- Number of pages
- 7
- Language
- English
- Date published
- 09/2013
- Academic Unit
- Anatomy and Cell Biology; Surgery
- Record Identifier
- 9985244576102771
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