Background: Following induction chemotherapy, both resection or irreversible electroporation (IRE) may further improve survival in patients with locally advanced pancreatic cancer (LAPC). However, prospective studies combining these strategies are currently lacking, and available studies only report on subgroups that completed treatment. This study aimed to determine the applicability and outcomes of resection and IRE in patients with nonprogressive LAPC after induction chemotherapy.
Methods: This was a prospective, single-center cohort study in consecutive patients with LAPC (September 2013 to March 2015). All patients were offered 3 months of induction chemotherapy (FOLFIRINOX or gemcitabine depending on performance status), followed by exploratory laparotomy for resection or IRE in patients with Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 nonprogressive, IRE-eligible tumors.
Results: Of 132 patients with LAPC, 70% (n = 93) started with chemotherapy (46% [n = 61] FOLFIRINOX). After 3 months, 59 patients (64%) had nonprogressive disease, of whom 36 (27% of the entire cohort) underwent explorative laparotomy, resulting in 14 resections (11% of the entire cohort, 39% of the explored patients) and 15 IREs (11% of the entire cohort, 42% of the explored patients). After laparotomy, 44% (n = 16) of patients had Clavien-Dindo grade 3 or higher complications, and 90-day all-cause mortality was 11% (n = 4). With a median follow-up of 24 months, median overall survival after resection, IRE, and for all patients with nonprogressive disease without resection/IRE (n = 30) was 34, 16, and 15 months, respectively. The resection rate in 61 patients receiving FOLFIRINOX treatment was 20%.
Conclusion: Induction chemotherapy followed by IRE or resection in nonprogressive LAPC led to resection or IRE in 22% of all-comers, with promising survival rates after resection but no apparent benefit of IRE, despite considerable morbidity. Registered at Netherlands Trial Register (NTR4230).
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1245/s10434-017-5900-9 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
ST elevation myocardial infarction as presenting feature of acute myeloid leukemia.
Med J Armed Forces India
December 2024
Professor (Clinical Hematology), Army Hospital (R & R), New Delhi, India.
A 35-year-old male patient with acute myeloid leukemia (AML), with hyperleukocytosis, presented with acute myocardial infarction. The individual had acute onset chest pain and reached the hospital within the window period. His electrocardiogram (ECG) revealed ST elevated myocardial infarction (STEMI), ST elevated myocardial infarction, and thrombolysis was performed.
View Article and Find Full Text PDFClinical impacts of total parenteral nutrition in hematopoietic stem cell transplantation patients with high nutritional risk.
Front Nutr
December 2024
Department of Pharmacy, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Background: Hematopoietic stem cell transplantation (HSCT) patients often receive consecutive intensive chemotherapy, which can lead to gastrointestinal complications and acute graft-versus-host disease (GVHD), placing patients at high nutritional risk.
Aim: This retrospective study aimed to evaluate the benefits of nutritional support in maintaining nutritional status, reducing weight loss without increasing the incidence of catheter-related bloodstream infections (CRBSI) or liver dysfunction, and improving clinical outcomes in HSCT patients at high nutritional risk.
Methods: A total of 526 patients who underwent HSCT were included in the study.
Ceftazidime-avibactam for the treatment of febrile neutropenia in HSCT recipients and acute leukemia patients post induction chemotherapy.
Sci Rep
December 2024
American University of Beirut, Cairo Street, Riad El Solh, PO Box 11-0236/11D, Beirut, 1107 2020, Lebanon.
Febrile neutropenia is a major complication in patients with acute leukemia or those undergoing hematopoietic stem cell transplantation (HSCT). Understanding patient characteristics and susceptibility patterns in febrile neutropenia is essential for appropriate antimicrobial therapy. First-line agents should have Pseudomonas aeruginosa coverage, but with the increase in multi-drug resistant organisms, ceftazidime-avibactam has emerged as a new therapeutic option.
View Article and Find Full Text PDFEfficacy and safety of low-dose TBI combined MAC regimen for HSCT in high-risk AML patients with active disease.
Ann Med
December 2025
Department of Hematology, Affiliated Hangzhou First People's Hospital, Westlake University, School of Medicine, Hangzhou, China.
Background: The management of high-risk acute myeloid leukaemia (AML) remains challenging, highlighting the need for innovative conditioning strategies beyond current regimens.
Methods: In the present single-arm study, a FACT regimen comprised of low-dose total body irradiation (TBI) with fludarabine, cytarabine and cyclophosphamide was employed to treat cytogenetically high-risk AML patients exhibiting pre-transplant active disease. This clinical trial is registered in the Chinese Clinical Trial Registry with the registration number ChiCTR2000035111.
Targeting mitochondrial RNAs enhances the efficacy of the DNA-demethylating agents.
Sci Rep
December 2024
Department of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34141, Korea.
Hypomethylating agents (HMAs) such as azacytidine and decitabine are FDA-approved chemotherapy drugs for hematologic malignancy. By inhibiting DNA methyltransferases, HMAs reactivate tumor suppressor genes (TSGs) and endogenous double-stranded RNAs (dsRNAs) that limit tumor growth and trigger apoptosis via viral mimicry. Yet, HMAs show limited effects in many solid tumors despite the strong induction of TSGs and dsRNAs.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!