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Concurrent chemotherapy alone versus irreversible electroporation followed by chemotherapy on survival in patients with locally advanced pancreatic cancer

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Abstract

Pancreatic adenocarcinoma is one of the most fatal cancers, characterized by aggressive tumor growth and a short patient survival time between diagnosis and death. Safe and effective treatment options are limited, especially in cases when surgical resection is not possible. Irreversible electroporation (IRE) is a non-thermal ablation technique recently introduced in the treatment of pancreatic cancer. From 2013 to 2016, 29 cases of locally advanced pancreatic cancer (LAPC) treated with IRE were retrospectively analyzed and the median overall survival (OS) rates were compared with patients with the same diagnosis who received standard chemotherapy as reported in the literature. Literature was selected according to a predetermined protocol. Secondarily, preoperative and postoperative Karnofsky scores of the 29 IRE-treated patients were compared to determine improvement in quality-of-life. Median OS of IRE-treated patients was 14 months (SE 11 months, 95% CI range 9.86–18.14). For IRE-treated patients, the Karnofsky score increased from Tzero to T3m by a mean of 28.28 (SE 2.11, 95% CI range 23.95–32.60). In 27 patients, 6-month imaging follow-up showed a mean lesion volumetric decrease percentage of 40.32% (SE 2.76, 95% CI 34.63–46.01%). Treatment with IRE followed by chemotherapy substantially increases median OS rate and quality-of-life of LAPC-diagnosed patients when compared to patients treated with traditional methods, including chemotherapy. Further investigation of this multi-modal treatment is warranted.

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Authors and Affiliations

  1. Department of Diagnostic Imaging, “S. Anna-S. Sebastiano” Hospital, Via F. Palasciano, 81100, Caserta, Italy

    Giuseppe Belfiore

  2. Department of Clinical and Experimental Medicine, “F. Magrassi - A. Lanzara” Second University of Naples, Piazza Miraglia 2, 80131, Naples, Italy

    Maria Paola Belfiore, Alfonso Reginelli & Salvatore Cappabianca

  3. Department of Medicine and Health Sciences, University of Molise, Via Francesco de Sanctis, 1, 86100, Campobasso, Italy

    Raffaella Capasso & Luca Brunese

  4. Department of Informatics, Second University of Naples, Piazza Miraglia 2, 80131, Naples, Italy

    Francesco Romano

  5. Department of Oncology, “S. Anna-S. Sebastiano” Hospital, Via F. Palasciano, 81100, Caserta, Italy

    Giovanni Pietro Ianniello

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  1. Giuseppe Belfiore
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  2. Maria Paola Belfiore
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Correspondence to Alfonso Reginelli.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Belfiore, G., Belfiore, M.P., Reginelli, A. et al. Concurrent chemotherapy alone versus irreversible electroporation followed by chemotherapy on survival in patients with locally advanced pancreatic cancer. Med Oncol 34, 38 (2017). https://doi.org/10.1007/s12032-017-0887-4

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  • DOI: https://doi.org/10.1007/s12032-017-0887-4

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