DUCTAL CANCER OF PANCREATIC HEAD NEOADJUVANT TREATMENT: CLOSE AND END RESULTS
Authors: R.I. Rasulov, M.V. Zemko, I.V. Ushakova, G.I. Songolov
Aim: study the possibility of neoadjuvant therapy in radical therapeutic regimen of resectable pancreatic head cancer.
Material and methods. 216 patients with ductal cancer of pancreatic head have been treated over the years of 2006–2016. Neoadjuvant treatment was applied in 45 cases, adjuvant treatment – in 101 cases, symptomatic operations – in 70 cases.
Results. Over gastroduodenal artery chemoembolization 11 (18,3%) assessments had complications; they were cut short in the course of conservative treatment in 2–5 days. At the stage of radiation therapy 14 (23,3%) assessments caused radiation injuries; erythema was cut short in 4-10 days, leukopenia – in one day after radiation therapy termination. Remote survival rate with inoperable neoplastic process where gastroduodenal artery chemoembolization and radiation therapy were applied, was: 1 year – 53,9%, 2 years – 10,7%, average-expectancy life – 8,9±1,58 months. Postoperative complications and mortality while neoadjuvant treatment were 40% and 2,2% respectively. Remote survival rate while neoadjuvant and adjuvant treatment of patients with resectable neoplastic process was respectively: 1 year – 63,0% and 51,8% (р=0,1), 2 years – 35,2% and 19,8% (р=0,02), 3 years – 25,2% and 14,4% (р=0,05), 4 years – 11,9% and 7,9% (р=0,3), 5 years – 8,9% and 5,2% (р=0,2), average-expectancy life – 27,8±4,27 и 15,5±1,65 (р=0,03) months.
Conclusion. At pre-operational stage there were some complications and radiation injuries that had been cut short with conservative actions and didn’t extend the duration of this period. Gastroduodenal artery chemoembolization and radiation therapy improved considerably remote survival rate of patients with inoperable neoplastic process. Gastroduodenal artery chemoembolization and radiation therapy didn’t change the character and didn’t increase post-operation morbidity and mortality. Resectable pancreatic head cancer combination therapy improved considerably remote survival rate in cases with metastatic lesions of regional and uxtaregional lymph nodes.