Maebayashi Toshiya, Ishibashi Naoya, Aizawa Takuya, Sakaguchi Masakuni, Sato Tsutomu, Kawamori Jiro, Tanaka Yoshiaki
Department of Radiology, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan.
Radiology Clinic, Sonoda Medical Corporations, Adachi-ku, Tokyo 121-0064, Japan.
Oncol Lett. 2017 Jun;13(6):4959-4964. doi: 10.3892/ol.2017.6066. Epub 2017 Apr 21.
Patients with locally advanced unresectable pancreatic cancer (LAUPC) have a poor prognosis. In addition their quality of life impaired by cancer pain and biliary tract infections. Therefore, multimodality therapy and selection of optimal treatment methods are essential for achieving prolonged survival. The present study investigated the significance of using hyperthermia concurrently with multimodality therapy to improve treatment outcomes in patients with LAUPC. In total, 13 patients receiving concurrent hyperthermia and chemoradiotherapy (HCR) or chemoradiotherapy (CR) alone for LAUPC between 2002 and 2013 were analyzed retrospectively. Of the 13 patients, 5 received concurrent HCR and 8 received CR. The chemotherapy regimens were 5-fluorouracil (5-FU) in 5 patients and gemcitabine hydrochloride (GEM) in the other 8. Patients who gave consent for hyperthermia treatment received GEM plus CR. The median overall survival period for all patients was 12 months and the 1-year survival rate was 55%; the corresponding values were 12 months and 57% in the GEM CR group, and 15 months and 80% in the HCR group. Univariate analyses was perfomed to identify factors predicting recurrence after treatment. The potential prognostic factors analyzed were: Age, sex, performance status, location, tumor size, the tumor marker CA 19-9, total radiation dose, chemotherapy and hyperthermia. Univariate analysis for factors associated with outcomes revealed a significant difference favoring the HCR group [relative risk=15.97 (95% confidence interval: 12.87-19.83) P=0.021]. In conclusion, hyperthermia merits active recommendation to pancreatic cancer patients who have a positive attitude toward this treatment and whose performance status is satisfactory.
局部晚期不可切除胰腺癌(LAUPC)患者预后较差。此外,他们的生活质量受到癌症疼痛和胆道感染的影响。因此,多模式治疗和选择最佳治疗方法对于延长生存期至关重要。本研究探讨了在LAUPC患者中同时使用热疗与多模式治疗以改善治疗效果的意义。回顾性分析了2002年至2013年间13例接受热疗与放化疗(HCR)或单纯放化疗(CR)联合治疗的LAUPC患者。13例患者中,5例接受了HCR联合治疗,8例接受了CR治疗。化疗方案中,5例患者使用5-氟尿嘧啶(5-FU),另外8例使用盐酸吉西他滨(GEM)。同意接受热疗的患者接受GEM加CR治疗。所有患者的中位总生存期为12个月,1年生存率为55%;GEM-CR组相应值为12个月和57%,HCR组为15个月和80%。进行单因素分析以确定治疗后预测复发的因素。分析的潜在预后因素包括:年龄、性别、体能状态、肿瘤位置、肿瘤大小、肿瘤标志物CA 19-9、总放疗剂量、化疗和热疗。对与预后相关因素的单因素分析显示,HCR组有显著差异[相对风险=15.97(95%置信区间:12.87-19.83),P=0.021]。总之,对于对热疗持积极态度且体能状态良好的胰腺癌患者,热疗值得积极推荐。