Safety and efficacy of perioperative chemoradiotherapy of resectable pancreatic cancer.

Abstract

Background: A novel treatment method involving neoadjuvant chemoembolization of tumor vessels prior to intraoperative radiotherapy followed by adjuvant chemotherapy was established for patients with resectable pancreatic cancer. The aim of the present study was to assess the safety and efficacy of this novel treatment scheme. Methods: Records of 114 patients with PDAC treated in Botkin Hospital between 2013-2016 were reviewed. In 28 cases a combination of neoadjuvant chemoembolization (NACE) and pancratic resection was used. 33 patients underwent complex treatment (IORT and pancreatic resection). In 23 cases perioperative chemoradiotherapy (PeriCRT), a novel method, was used. 30 patients were treated by a standard scheme (pancreatic resection and adjuvant chemotherapy). Afterward a histological examination and electron microscopy of irradiated resection margin were performed. Results: All 114 patients underwent gross total resection. By the end of the study only patients in the control group had local reccurence (3/30). The estimated median survival was 336, 356, 359 and 333 days. Long-term survival was 78,6% (NACE), 87,9% (IORT), 95,7% (PeriCRT), 73,3% (control) for one-year survival, respectively (P=0,0257, 95% Cl). All treatment methods were well tolerated by all patients, with few adverse effects and no serious complications. Conclusion: Excellent local control and one-year OS for resected PDAC was achieved by using novel PeriCRT treatment method.