Abstract 71P
Background
Locally advanced pancreatic cancer (LAPC) represents more than one third of pancreatic cancers and owns poor survival after the standard chemotherapy. Irreversible electroporation (IRE) is a novel method and has been recently used in LAPC. The aim of this study was to compare the efficacy of IRE and radiotherapy after induction chemotherapy for patients with LAPC.
Methods
From August 2015 to August 2017, a total of 76 patients with biopsy proven LAPC and who had received IRE or radiotherapy after chemotherapy were included. Thirty-two pairs of patients were selected through propensity score matching (PSM) analysis and the efficacy of two treatments was compared.
Results
Before PSM analysis, after induction chemotherapy, patients with LAPC benefited more in terms of overall survival (OS) and progression free survival (PFS) from IRE, compared with radiotherapy (2-year OS rates, 53.5% vs 26.9%, p = 0.039; 2-year PFS rates, 28.4% vs 13.3%, p = 0.045). After PSM analysis, the survival benefits of OS and PFS of patients after induction chemotherapy followed by IRE were more obvious than those of patients treated with radiotherapy (2-year OS rates, 53.5% vs 20.7%, p = 0.011; 2-year PFS rates, 28.4% vs 5.6%, p = 0.004). Multivariate Cox regression analysis indicated that IRE after induction chemotherapy was identified as a significant favourable factor for both OS and PFS in both the whole and matched cohort. Comparison of toxicity and complications between two groups.Table: 71P
Complications | Chemotherapy + IRE | Chemotherapy + radiotherapy | P value |
---|---|---|---|
All | 36 | 36 | |
Toxicity | |||
Neutropenia | 1 | 12 | 0.001 |
Lymphopenia | 2 | 10 | 0.024 |
Hypoalbuminemia | 3 | 7 | 0.307 |
Hypotension | 3 | 5 | 0.710 |
Hypokalemia | 2 | 7 | 0.151 |
Fatigue | 2 | 10 | 0.024 |
Vomiting | 0 | 9 | 0.002 |
Diarrhea | 2 | 9 | 0.046 |
Complications | |||
Thrombosis | 4 | 5 | 0.890 |
Ascites | 1 | 6 | 0.107 |
Abdominal pain | 2 | 8 | 0.085 |
Muscle weakness | 1 | 10 | 0.006 |
Conclusions
Induction chemotherapy followed by IRE is superior to induction chemotherapy followed by radiotherapy for treating LAPC. A randomized clinical trial comparing the efficacy of IRE and radiotherapy after the induction chemotherapy is therefore considerable.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Chaobin He.
Funding
National Natural Science Foundation of China (81171890; 81672390), and the Major National Scientific Research Projects of China (No. 2013CB910304).
Disclosure
All authors have declared no conflicts of interest.
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