Kouda Ken, Asaeda Makoto, Nakashima Yuki, Araki Takeya, Kawasaki Shinji, Ishida Ayano, Nagao Takumi, Maeda Noriaki, Urabe Yukio, Mikami Yukio
Department of Rehabilitation Medicine, Wakayama Medical University, Japan.
Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital.
Integr Cancer Ther. 2025 Jan-Dec;24:15347354251349775. doi: 10.1177/15347354251349775. Epub 2025 Jun 29.
Preoperative chemotherapy in borderline resectable pancreatic cancer (BRPC) reduces tumor size to enable surgery but may cause physical function decline. This study aimed to examine changes in physical function before and after preoperative chemotherapy in patients with BRPC, and explored factors associated with the change.
This retrospective study included 17 patients with BRPC who underwent preoperative chemotherapy and surgery between January 2020 and December 2021. Physical function was assessed using grip strength and the 6-minute walking test (6MWT). Patients were divided into 2 groups based on changes in physical function: (1) those with maintained physical function and (2) those with reduced physical function. Physical function, treatment duration, and the number of chemotherapy sessions were compared between the groups.
Grip strength (24.7 ± 6.8 vs 25.1 ± 6.8 kg, = .462) and 6MWT (451.8 ± 95.7 vs 470.0 ± 82.5 m, = .119) showed no significant decline after chemotherapy. On subgroup analysis, the reduced physical function group (6 patients) had significantly more chemotherapy sessions than the maintained group (5.0 ± 2.0 vs 2.0 ± 0.6, = .042), suggesting that prolonged chemotherapy regimens may increase physical function decline risk due to cumulative toxicity.
These findings underscore the need for individualized treatment planning, balancing tumor reduction benefits with physical decline risk, especially in frail patients.
可切除边缘性胰腺癌（BRPC）患者术前化疗可缩小肿瘤大小以利于手术，但可能导致身体功能下降。本研究旨在探讨BRPC患者术前化疗前后身体功能的变化，并探索与该变化相关的因素。
本回顾性研究纳入了2020年1月至2021年12月期间接受术前化疗和手术的17例BRPC患者。使用握力和6分钟步行试验（6MWT）评估身体功能。根据身体功能变化将患者分为两组：（1）身体功能维持组和（2）身体功能下降组。比较两组的身体功能、治疗持续时间和化疗疗程数。
化疗后握力（24.7±6.8 vs 25.1±6.8 kg，P = 0.462）和6MWT（451.8±95.7 vs 470.0±82.5 m，P = 0.119）均无显著下降。亚组分析显示，身体功能下降组（6例患者）的化疗疗程明显多于身体功能维持组（5.0±2.0 vs 2.0±0.6，P = 0.042），这表明延长化疗方案可能因累积毒性增加身体功能下降风险。
这些发现强调了个性化治疗计划的必要性，要在肿瘤缩小益处与身体功能下降风险之间取得平衡，尤其是对于身体虚弱的患者。
