Intraoperative electrochemotherapy in locally advanced pancreatic cancer: indications, techniques and results-a single-center experience.
Aged
Antineoplastic Agents
/ administration & dosage
Bleomycin
/ administration & dosage
Chemoradiotherapy
Combined Modality Therapy
Electrochemotherapy
/ methods
Electroporation
/ methods
Female
Humans
Intraoperative Care
/ methods
Laparotomy
Male
Middle Aged
Palliative Care
/ methods
Pancreatectomy
/ methods
Pancreatic Neoplasms
/ pathology
Quality of Life
Surgery, Computer-Assisted
Treatment Outcome
Bleomycin
Electrochemotherapy
Electroporation
Locally advanced pancreatic cancer
Journal
Updates in surgery
ISSN: 2038-3312
Titre abrégé: Updates Surg
Pays: Italy
ID NLM: 101539818
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
09
03
2020
accepted:
29
04
2020
pubmed:
14
5
2020
medline:
2
1
2021
entrez:
14
5
2020
Statut:
ppublish
Résumé
Locally advanced pancreatic cancer (LAPC) is usually treated with chemoradiotherapy with poor results. The aim of the study was to assess whether intraoperative electrochemotherapy could be proposed as additional therapy in treating LAPC. Observational study of patients affected by LAPC who underwent intraoperative electrochemotherapy (ECT) after chemoradiotherapy. Data at diagnosis, at restaging and short and long-term outcomes, including assessment of quality of life, were collected for each patient. Five patients underwent ECT: in four cases, the tumours were located in the head and, in one, in the body of the pancreas. Preoperative chemotherapy consisted mainly of six cycles of modified Folfirinox. At restaging, the serum value of carbohydrate antigen (Ca 19-9) and tumour size were reduced; however, the vascular involvement did not change. No downstaging was recorded. The ECT procedure was performed using at least four needles with a mean duration time of 27 min (range 15-40). No postoperative mortality or major complications were reported. The mean length of stay (LOS) was 8 days (range 5-14). Four patients were alive and well at the end of the study, while one patient died from disease progression. The mean follow-up was 20.8 months (range 9-34) from diagnosis and 9.4 months (range 2-19) from ECT. The quality of life was good and there was improvement in pain/discomfort. Electrochemotherapy could be proposed as a simple, feasible and safe palliative additional treatment in LAPC without progression after chemoradiotherapy. It seems to allow a good quality of life and pain improvement.
Sections du résumé
BACKGROUND
BACKGROUND
Locally advanced pancreatic cancer (LAPC) is usually treated with chemoradiotherapy with poor results. The aim of the study was to assess whether intraoperative electrochemotherapy could be proposed as additional therapy in treating LAPC.
METHODS
METHODS
Observational study of patients affected by LAPC who underwent intraoperative electrochemotherapy (ECT) after chemoradiotherapy. Data at diagnosis, at restaging and short and long-term outcomes, including assessment of quality of life, were collected for each patient.
RESULTS
RESULTS
Five patients underwent ECT: in four cases, the tumours were located in the head and, in one, in the body of the pancreas. Preoperative chemotherapy consisted mainly of six cycles of modified Folfirinox. At restaging, the serum value of carbohydrate antigen (Ca 19-9) and tumour size were reduced; however, the vascular involvement did not change. No downstaging was recorded. The ECT procedure was performed using at least four needles with a mean duration time of 27 min (range 15-40). No postoperative mortality or major complications were reported. The mean length of stay (LOS) was 8 days (range 5-14). Four patients were alive and well at the end of the study, while one patient died from disease progression. The mean follow-up was 20.8 months (range 9-34) from diagnosis and 9.4 months (range 2-19) from ECT. The quality of life was good and there was improvement in pain/discomfort.
CONCLUSIONS
CONCLUSIONS
Electrochemotherapy could be proposed as a simple, feasible and safe palliative additional treatment in LAPC without progression after chemoradiotherapy. It seems to allow a good quality of life and pain improvement.
Identifiants
pubmed: 32399592
doi: 10.1007/s13304-020-00782-x
pii: 10.1007/s13304-020-00782-x
doi:
Substances chimiques
Antineoplastic Agents
0
Bleomycin
11056-06-7
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1089-1096Références
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