LONG-TERM RESULTS OF COMBINED X-RAY ENDOVASCULAR SURGICAL TREATMENT OF PATIENTS WITH DUCTAL ADENOCARCINOMA OF THE PANCREATIC HEAD
https://doi.org/10.24884/0042-4625-2013-172-4-040-043
Abstract
On the basis of the results of treatment of 105 patients with locally advanced ductal adenocarcinoma of the pancreatic head the authors present the results of work over a period of time since 1999 to 2009. In the main group the combined treatment was used for 51 patients: the non-adjuvant selective chemoembolization of the pancreatic head adenocarcinoma was performed, than standard gastropancreatoduodenal resection with lymphodesection and 6 cycles of adjuvant chemoinfusion in celiac trunk were completed. In control group standard gastropancreatoduodenal resection was performed. In the group of combined treatment the 1-, 2-, 3-year survival rates consist of 80.4%, 58.8% and 43.1%, respectively. The average life span was 22.3±2.1 months. The average life span of 54 patient of control group was 8.4±2.1 months and a common 3-year survival consists of 13%. There was no lethality after the performance of X-ray endovascular procedures and gastropancreatoduodenal resection. Postoperative complications reliably didn’t differ in both groups.
About the Authors
A. A. Polikarpov
Russian research centre of radiology and surgical technology
Russian Federation
Russian Federation
A. V. Pavlovsky
Russian research centre of radiology and surgical technology
Russian Federation
Russian Federation
A. S. Gulo
Russian research centre of radiology and surgical technology
Russian Federation
Russian Federation
A. S. Popov
Russian research centre of radiology and surgical technology
Russian Federation
Russian Federation
P. G. Tarazov
Russian research centre of radiology and surgical technology
Russian Federation
Russian Federation
D. A. Granov
Russian research centre of radiology and surgical technology
Russian Federation
Russian Federation
References
1. Гранов Д. А., Павловский А. В., Таразов П. Г. Масляная артериальная химиоэмболизация: новый способ терапии рака поджелудочной железы // Вопр. онкол. 2003. № 5. C. 579–583.
2. Кубышкин В. А., Щеголев А. И., Балукова О. В., Кочатков А. В. Отдаленные результаты лечения протоковой аденокарциномы головки поджелудочной железы: факторы, влияющие на прогноз течения заболевания // Анн. хир. гепатол. 2004. № 1. С. 129–134.
3. Патютко Ю. И., Котельников А. Г. Хирургия рака органов билиопанкреатодуоденальной зоны. М.: Медицина, 2007. 356 с.
4. Патютко Ю. И., Сагайдак И. В. Диагностика и лечение рака поджелудочной железы // Вестн. Российского онкол. научного центра им. Н. Н. Блохина РАМН. 2006. № 2. С. 37–38.
5. Путов Н. В., Артемьева Н. Н., Коханенко Н. Ю. Рак поджелудочной железы. СПб.: Питер, 2005. 416 с.
6. Polikarpov A. A., Pavlovskij A. V., Tarazov P. G., Granov D. A. Transcatheter arterial oily chemoembolization (TAOCE) in the treatment of pancreatic cancer: First experience // Ann. Oncol. 2000. Vol. 11. Р. 144.
7. Способ лечения злокачественных опухолей поджелудочной железы // Патент на изобретение № 2156137 / А. В. Павловский, П. Г. Таразов, Д. А. Гранов; 05.10.1999.
8. Abrams R., Winter K., Regine W. et al. Failure to adhere to protocol specified radiation therapy guidelines was associated with decreased survival in RTOG 9704- a phase III trial of adjuvant chemotherapy and chemoradiotherapy for patients with resected adenocarcinoma of the pancreas // Int. J. Radiat. Oncol. Biol. Phys. 2012. Vol. 82, № 2. Р. 809–816.
9. Alexakis N., Halloran C., Raraty M. et.al. Current standards of surgery for pancreatic cancer // Br. J. Surg. 2004. Vol. 91, № 11. Р. 1410–1427.
10. Golcher H., Brunner T., Grabenbauer G. et al. Preoperative chemoradiation in adenocarcinoma of the pancreas. A single centre experience advocating a new treatment strategy // Eur. J. Surg. Oncol. 2008. Vol. 34, № 7. Р. 756–764.
11. Eshuis W., van der Gaag N., Rauws E. et.al. Therapeutic delay and survival after surgery for cancer of the pancreatic head with or without preoperative biliary drainage // Ann. Surg. 2010. Vol. 252, № 5. Р. 840–849.
12. Kneuertz P., Cunningham S., Cameron J. et al. Palliative surgical management of patients with unresectable pancreatic adenocarcinoma: trends and lessons learned from a large, single institution experience // J. Gastrointest. Surg. 2011. Vol. 15, № 11. Р. 1917–1927.
13. Kure S., Kaneko T., Takeda S. Analysis of long-term survivors after surgical resection for invasive pancreatic cancer // HPB. 2005. Vol. 7, № 2. Р. 129–134.
14. Lorgis V., Chauffert B., Gentil J., Ghiringhelli F. Influcence of localization of primary tumor on effectiveness of 5-fluorouracil/ leucovorin combined with irinotecan and oxaliplatin (FOLFIRINOX) in patients with metastatic pancreatic adenocarcinoma: a retrospective study. // Anticancer Res. 2012. Vol. 32, № 9. Р. 4125–4130.
15. Lygidakis N., Dedemati G., Spenzaris N., Theodoropoulou M. Unresectable pancreatic cancer: is a multi-modality approach a promising therapeutical alternative // Hepatogastroenterol. 1997. Vol. 44, № 16. Р. 1222–1228.
16. Neoptolemos J., Stocken D., Friess H. et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer // N. Eng. J. Med. 2004. Vol. 350. Р. 1200–1210.
17. Ouaïssi M., Giger U., Louis G. et al. Ductal adenocarcinoma of the pancreatic head: a focus on current diagnostic and surgical concepts // World J. Gastroenterol. 2012. Vol. 28, № 24. Р. 3058–3069.
18. Papalezova K., Tyler D., Blazer D. et al. Does preoperative therapy optimize outcomes in patients with resectable pancreatic cancer? // J. Surg. Oncol. 2012. Vol. 106, № 1. Р. 111–118.
19. Picozzi V., Abrams R., Decker P. et al. Multicenter phase II trial of adjuvant therapy for resected pancreatic cancer using cisplatin, 5-fluorouracil, and interferon-alfa-2b-based chemoradiation: ACOSOG trial Z05031 // Ann. Oncol. 2011. Vol. 22, № 2. Р. 348–354.
20. Tajima H., Ohta T., Kitagawa H. et al. Pilot study of neoadjuvant chemotherapy with gemcitabine and oral S-1 for resectable pancreatic cancer // Exp. Ther. Med. 2012. Vol. 3, № 5. Р. 787–792.
21. Wente M., Shrikhande S., Müller M. et al. Pancreaticojejunostomy versus pancreaticogastrostomy: systematic review and meta-analysis // Am. J. Surg. 2007. Vol. 193, № 2. Р. 171–183.
Review
For citations:
Polikarpov A.A., Pavlovsky A.V., Gulo A.S., Popov A.S., Tarazov P.G., Granov D.A. LONG-TERM RESULTS OF COMBINED X-RAY ENDOVASCULAR SURGICAL TREATMENT OF PATIENTS WITH DUCTAL ADENOCARCINOMA OF THE PANCREATIC HEAD. Grekov's Bulletin of Surgery. 2013;172(4):040-043. (In Russ.) https://doi.org/10.24884/0042-4625-2013-172-4-040-043
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