Clinical and immunological evaluation of intraoperative radiation therapy for patients with unresectable pancreatic cancer

Yamaue, Hiroki; Tanimura, Hiroshi; Aoki, Yozo; Tsunoda, Takuya; Itō, Makoto; Tani, Masaji; Tamai, Mikiko; Noguchi, Kohei; Kashiwagi, Hirotaka; Sasaki, Masakazu; Yamada, Ryusaku

doi:10.1002/jso.2930490104

Cited by 10 publications

(7 citation statements)

References 19 publications

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“…5 Indeed, our patient had a duodenal outlet obstruction, and thus had to undergo a bypass operation. We previously reported that IORT has immunoregulatory effects which do not inhibit antitumor immunity, 6 and IORT may thus translate into an extended survival in our patient.…”

Section: Discussionmentioning

confidence: 90%

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Intraoperative radiation therapy for a patient with bulky disease of mesenteric non-Hodgkin’s lymphoma

et al. 1998

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A long survival is rarely observed in patients demonstrating recurrent malignant lymphoma with bulky disease because of the appearance of chemoresistant tumor cells after extensive chemotherapy, and moreover the presence of bulky disease has also been consistently associated with a poorer response rate and a shortened survival, due to the fact that tumor size is the most significant factor for the treatment of non-Hodgkin's lymphoma. We herein describe a case of a 53-year-old woman presenting with the chief complaint of abdominal fullness, who underwent intraoperative radiation therapy (IORT) for recurrent bulky non-Hodgkin's lymphoma in the mesenterium. The patient has had no evidence of tumor recurrence, based on the findings of regular abdominal computed tomographic scans, 60 months after initial chemotherapy and 28 months after IORT.

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Section: Discussionmentioning

confidence: 90%

“…5 In IORT a high single radiation dose should be delivered to a surgically defined area, while carefully protecting all uninvolved organs and tissue. 6 The present case report is the first to describe the therapeutic effects of IORT for bulky non-Hodgkin's lymphoma developing in a patient after undergoing extensive multiagent chemotherapy.…”

Section: Introductionmentioning

confidence: 95%

Intraoperative radiation therapy for a patient with bulky disease of mesenteric non-Hodgkin’s lymphoma

et al. 1998

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“…Multiple studies focusing on patients with cancer undergoing radiotherapy also unveiled reductions in the absolute number of various peripheral blood (PB) lymphocyte subsets, including NK cells [ 19 , 20 , 21 , 22 , 23 , 24 , 25 ], and impaired NK cell activity compared to pre-treatment levels [ 26 , 27 ], suggesting that radiotherapy directly decreases both NK cell viability and function in a dose-dependent manner.…”

Section: Radiotherapymentioning

confidence: 99%

Natural Killer Cells and Anti-Cancer Therapies: Reciprocal Effects on Immune Function and Therapeutic Response

Toffoli

Sheikhi

Höppner

et al. 2021

Cancers

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Natural Killer (NK) cells are innate immune cells with the unique ability to recognize and kill virus-infected and cancer cells without prior immune sensitization. Due to their expression of the Fc receptor CD16, effector NK cells can kill tumor cells through antibody-dependent cytotoxicity, making them relevant players in antibody-based cancer therapies. The role of NK cells in other approved and experimental anti-cancer therapies is more elusive. Here, we review the possible role of NK cells in the efficacy of various anti-tumor therapies, including radiotherapy, chemotherapy, and immunotherapy, as well as the impact of these therapies on NK cell function.

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“…Unfortunately, IORT may also inhibit the activity of tumour infiltrating lymphocytes. The restriction of this natural killer activity means that IORT is best provided with biological response modifiers to counter such inhibition of local immunity 165 if the theoretical advantages provided by IORT are to be fully translated into survival benefit for patients.…”

Section: The Role Of Radiotherapy or Chemoradiotherapymentioning

confidence: 99%

Review article: current treatment and optimal patient management in pancreatic cancer

Haycox

Lombard

Neoptolemos

et al. 1998

Aliment Pharmacol Ther

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This review analyses the current state of knowledge and understanding concerning the optimum treatment and therapeutic management of patients who suffer from pancreatic cancer. It outlines recent advances in scientific understanding and assesses their potential future value to clinicians in confronting this disease. Despite a significant expansion in scientific knowledge relating to factors underlying the early development of pancreatic carcinoma, the clinician continues to be restricted to a severely limited therapeutic armoury for this disease. Local therapies (surgery and radiation) are inevitably of limited value in the face of a disease that is normally encountered at a stage where metastasis is already highly developed. Despite such limitations, however, surgery performed in specialist units may be of value for 10-20% of patients, with a 5-year survival rate in such units of between 10 and 24%. This may be improved even further by appropriate use of adjuvant treatment. The advanced stage of the disease when normally encountered emphasizes the potential value of systemic treatment in this therapeutic area. Unfortunately systemic treatment (chemotherapy) has been found to be ineffective to date in significantly extending survival, with a low rate and duration of remission being identified in most trials. The challenge for both the health service and the pharmaceutical industry is to harness recent and future developments in scientific knowledge to the practical benefit of clinicians. Where cure is possible it should be vigorously pursued; where it is not, in this field above all others, clinicians have a duty of care. To achieve this it is necessary to abandon the therapeutic nihilism that has characterized the attitudes of clinicians towards this disease in the past. It is time that such nihilism was replaced by a recognition of the challenges and the opportunities available to clinicians in enhancing the quantity and quality of life available to patients. The dictum of 'curing whenever possible but caring always' should be the future therapeutic philosophy used to guide clinicians in this important and rapidly changing therapeutic area.

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Clinical and immunological evaluation of intraoperative radiation therapy for patients with unresectable pancreatic cancer

Cited by 10 publications

References 19 publications

Intraoperative radiation therapy for a patient with bulky disease of mesenteric non-Hodgkin’s lymphoma

Intraoperative radiation therapy for a patient with bulky disease of mesenteric non-Hodgkin’s lymphoma

Natural Killer Cells and Anti-Cancer Therapies: Reciprocal Effects on Immune Function and Therapeutic Response

Review article: current treatment and optimal patient management in pancreatic cancer

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