Feasibility and Efficacy of Combination Therapy With Preoperative Full-Dose Gemcitabine, Concurrent Three-Dimensional Conformal Radiation, Surgery, and Postoperative Liver Perfusion Chemotherapy for T3-Pancreatic Cancer

Abstract

Results of this trial suggest that a combination of preoperative full-dose gemcitabine, concurrent 3D-conformal radiation, surgery, and postoperative LPC is feasible for the treatment of T3-pancreatic cancer. Using the method described in this article, we were able to effectively reduce the incidence of both local and liver recurrence. Therefore, this type of combination therapy seems promising for improving long-term outcomes for patients with T3-cancers of the pancreas. This study is registered with University hospital Medical information Network clinical trials Registry number, UMIN000001804.

Real‐time detection of hepatic micrometastases from pancreatic cancer by intraoperative fluorescence imaging

“…[24][25][26][27] In addition, because systemic chemotherapy failed to prevent deterioration of hepatic disease, some liver-directed treatments may be needed for pancreatic cancer with hepatic micrometastases. [28][29][30][31][32] It is noteworthy that we observed hepatic recurrence after surgery in 60% of the patients who had false-positive hepatic fluorescence on PDE examination. This finding leads us to hypothesize that some of the cases of false-positive fluorescence were not ''true'' false-positives and, instead, were either extremely small micrometastases that could not be detected by histologic examination or the result of inadequate collection of biopsy samples.…”

Cyclin G2: A novel independent prognostic marker in pancreatic cancer

“…Gemcitabine (GEM)-based chemotherapy is the core of multimodal therapy for pancreatic cancer and has improved patient prognosis (3). Multimodal therapies that include both chemotherapy and radiation therapy have been previously investigated and are able to reportedly improve the clinical outcome in pancreatic cancer patients (4)(5)(6). This provides several therapeutic pathways to help reduce the high refractoriness of pancreatic cancer.…”

Pre-treatment neutrophil to lymphocyte ratio as a predictive marker for pathological response to preoperative chemoradiotherapy in pancreatic cancer

“…Gemcitabine (GEM)-based chemotherapy forms the core of multimodal therapy and has improved the prognosis of patients with pancreatic cancer (3). Multimodal therapies including preoperative treatments have been investigated, and studies indicate that preoperative chemoradiotherapy followed by surgery may improve the clinical outcome by reducing the frequency of local recurrence and increasing the 5-year survival rate in pancreatic cancer patients (4)(5)(6)(7)(8). However, in cases where preoperative therapy is not sufficiently effective and extensive tumor growth occurs, chemotherapy may unnecessarily increase the time between diagnosis and surgery, and may result in the patient missing the opportunity for surgical resection.…”