71P - Irreversible electroporation versus radiotherapy after induction chemotherapy on survival in patients with locally advanced pancreatic cancer: A propensity score analysis

Abstract

BackgroundLocally advanced pancreatic cancer (LAPC) represents more than one third of pancreatic cancers and owns poor survival after the standard chemotherapy. Irreversible electroporation (IRE) is a novel method and has been recently used in LAPC. The aim of this study was to compare the efficacy of IRE and radiotherapy after induction chemotherapy for patients with LAPC. MethodsFrom August 2015 to August 2017, a total of 76 patients with biopsy proven LAPC and who had received IRE or radiotherapy after chemotherapy were included. Thirty-two pairs of patients were selected through propensity score matching (PSM) analysis and the efficacy of two treatments was compared. ResultsBefore PSM analysis, after induction chemotherapy, patients with LAPC benefited more in terms of overall survival (OS) and progression free survival (PFS) from IRE, compared with radiotherapy (2-year OS rates, 53.5% vs 26.9%, p = 0.039; 2-year PFS rates, 28.4% vs 13.3%, p = 0.045). After PSM analysis, the survival benefits of OS and PFS of patients after induction chemotherapy followed by IRE were more obvious than those of patients treated with radiotherapy (2-year OS rates, 53.5% vs 20.7%, p = 0.011; 2-year PFS rates, 28.4% vs 5.6%, p = 0.004). Multivariate Cox regression analysis indicated that IRE after induction chemotherapy was identified as a significant favourable factor for both OS and PFS in both the whole and matched cohort. Comparison of toxicity and complications between two groups.Table71PTableComplicationsChemotherapy + IREChemotherapy + radiotherapyP valueAll3636ToxicityNeutropenia1120.001Lymphopenia2100.024Hypoalbuminemia370.307Hypotension350.710Hypokalemia270.151Fatigue2100.024Vomiting090.002Diarrhea290.046ComplicationsThrombosis450.890Ascites160.107Abdominal pain280.085Muscle weakness1100.006 ConclusionsInduction chemotherapy followed by IRE is superior to induction chemotherapy followed by radiotherapy for treating LAPC. A randomized clinical trial comparing the efficacy of IRE and radiotherapy after the induction chemotherapy is therefore considerable. Legal entity responsible for the studyChaobin He. FundingNational Natural Science Foundation of China (81171890; 81672390), and the Major National Scientific Research Projects of China (No. 2013CB910304). DisclosureAll authors have declared no conflicts of interest.