Investigation of neoadjuvant therapy for borderline resectable pancreatic cancer

Abstract

Aim: Although there are a few reports on the efficacy of neoadjuvant therapy (NAT) as a treatment for borderline resectable pancreatic carcinoma (BRPC), the topic remains controversial. Therefore, we conducted a retrospective study to analyze the long-term outcome. Method: Fifty-one patients who underwent neoadjuvant chemotherapy (NAC) or neoadjuvant chemoradiotherapy (NACRT) for BRPC at our hospital, between April 2003 and September 2019 were recruited in this study. Result: Altogether, 51 patients were diagnosed with BRPC based on the General Rules for the Study of Pancreatic Cancer (7th edition), of which, 15 had NAC, and 36 underwent NACRT. In total, 33 patients underwent resection of the pancreas (10 from NAC group (66.7%) and 23 from NACRT group (63.9%)), and 32 had radical surgery (9 from NAC group (60.0%) and 23 from NACRT group (63.9%)). R0 resection rate was 50% (16/32), and there was no significant difference between the NAC and NACRT groups (44.4% vs. 52.2%, P = 0.16). OS (21.0 months vs. 36.1 months, P = 0.974) and RFS (20.0 months vs. 24.0 months, P = 0.266) showed no significant differences between the NAC and NACRT groups. As revealed by the pathological findings, the percentage of patients with positive dissected peripancreatic tissue margin was significantly lower for the NACRT group than that of the NAC group (66.7% vs. 26.1%, P = 0.033). Conclusion: Although no significant difference was observed regarding long-term prognosis between the NAC and the NACRT groups, the results indicate the effectiveness of radiotherapy in local tumor control of BRPC.