PROSPECTS FOR NEOADJUVANT TREATMENT OF AMPULLARY CANCER (28-36)

PROSPECTS FOR NEOADJUVANT TREATMENT OF AMPULLARY CANCER (28-36)

Выбор валюты
Дата публикации статьи в журнале: 2020/10/12
Название журнала: Американский Научный Журнал, Выпуск: 41, Том: 3, Страницы в выпуске: 28-36
Автор:
Irkutsk, Department of Oncology, Branch of the Russian Medical Academy of Continuing Professional Education, Ministry of Health of the Russian Federation,
Автор: Dvornichenko V.V.
Irkutsk, Department of Oncology, Branch of the Russian Medical Academy of Continuing Professional Education, Ministry of Health of the Russian Federation, SBHI "Regional Oncological Dispensary",
Автор: Nazarova D.V.
Irkutsk, SBHI "Regional Oncological Dispensary",
Анотация: Objective: to study the possibilities of preoperative radiation therapy in a radical treatment regimen for glandular ampullary cancer. Materials and methods. In 2001-2019, 21 cases of pancreatic-biliary type of ampullary cancer underwent radical treatment, including preoperative RT, extended GPDR and adjuvant chemotherapy according to indications (experimental group), 48 cases of pancreatic-biliary type of ampullary cancer underwent expanded GPDR and adjuvant chemotherapy according to indications (control group), and 43 cases of intestinal type of ampullary cancer underwent extended GPDR and adjuvant chemotherapy according to indications. Results. Radiation therapy caused radiation injuries in 28.6% of patients: grade 1 erythema (19.1%), grade 1 leukopenia (4.75%), and grade 2 leukopenia (4.75%). Postoperative complications, mortality of the experimental group and the control group, respectively, amounted to 28.6% and 50.0% (p = 0.09) and 4.8% and 6.3% (p = 0.8). The overall 5-year survival rate, the average life expectancy of the experimental group and the control group, respectively, were 50.7% and 9.8% (p = 0.01) and 74.8 ± 12.58 months and 21.7 ± 6.11 months (p = 0.0008). The overall 5-year survival rate, the average life expectancy of the group with intestinal ampullary cancer, were 61.3% and 60.5 ± 9.15 months, respectively. Relapse-free survival of patients with glandular ampullary cancer (n = 112) who received treatment according to the radical regimen was: 1-year - 77.8%, 3-year - 51.0%, 5-year - 35.2%, average life expectancy - 44.7 ± 5.44 months Conclusion. Radiation injuries were stopped by conservative measures and did not increase the duration of the preoperative period. Preoperative RT in the radical treatment regimen for pancreatic-biliary type of ampullary cancer neither changed the nature nor increased the incidence of postoperative complications. Combined treatment significantly improved long-term survival in cases with pancreatic-biliary type of ampullary cancer.
Ключевые слова: ampullary cancer  pancreatic-biliary type  preoperative radiation therapy                
DOI: 10.31618/asj.2707-9864.2020.3.41.34
Данные для цитирования: Rasulov R.I. Dvornichenko V.V. Nazarova D.V.. PROSPECTS FOR NEOADJUVANT TREATMENT OF AMPULLARY CANCER (28-36). Американский Научный Журнал. Медицинские науки. 2020/10/12; 41(3):28-36. 10.31618/asj.2707-9864.2020.3.41.34

Список литературы: 1. Dorandeu A, Raoul JL, Siriser F, Leclercq- Rioux N, Gosselin M, Martin ED, Ramée MP, Launois B. Carcinoma of the ampulla of Vater: prognostic factors after curative surgery: a series of 45 cases. Gut. 1997 Mar;40(3):350-5. PubMed PMID: 9135524; PubMed Central PMCID: PMC1027085. 2. Casaretto E, Andrada DG, Granero LE. [Results of cephalic pancreaticoduodenectomy for ampullary carcinoma. Analysis of 18 consecutive cases]. Acta Gastroenterol Latinoam. 2010 Mar;40(1):22-31. Spanish. PubMed PMID: 20446393. 3. Zhou J, Zhang Q, Li P, Shan Y, Zhao D, Cai J. Prognostic factors of carcinoma of the ampulla of Vater after surgery. Tumour Biol. 2014 Feb;35(2):1143-8. doi: 10.1007/s13277-013-1153-9. Epub 2013 Sep 12. PubMed PMID: 24026886. 4. Balachandran P, Sikora SS, Kapoor S, Krishnani N, Kumar A, Saxena R, et al. Long-term survival and recurrence patterns in ampullary cancer. Pancreas. 2006;32:390–395. doi: 10.1097/01.mpa.0000220864.80034.63. 5. Junrungsee S, Kittivarakul E, Ko-iam W, Lapisatepun W, Sandhu T, Chotirosniramit A. Prognostic Factors and Survival of Patients with Carcinoma of the Ampulla of Vater after Pancreaticoduodenectomy. Asian Pac J Cancer Prev. 2017 Jan 1;18(1):225-229. doi: 10.22034/APJCP.2017.18.1.225. PMID: 28240523; PMCID: PMC5563104. 6. Murakami T, Matsuyama R, Ueda M, et al. High-Mobility Group Box 1 expression predicts survival of patients after resection of adenocarcinoma of the ampulla of Vater. World J Surg Oncol. 2019;17(1):140. Published 2019 Aug 9. doi:10.1186/s12957-019-1675-8. 7. Sato Y, Hara T, Takami Y, et al. Conversion surgery for initially unresectable carcinoma of the ampulla of Vater following pathological complete response to chemotherapy: a case report. Surg Case Rep. 2019;5(1):122. Published 2019 Jul 30. doi:10.1186/s40792-019-0680-z. 8. Zimmermann C, Wolk S, Aust DE, Meier F, Saeger HD, Ehehalt F, Weitz J, Welsch T, Distler M. The pathohistological subtype strongly predicts survival in patients with ampullary carcinoma. Sci Rep. 2019 Sep 3;9(1):12676. doi: 10.1038/s41598-01949179-w. PubMed PMID: 31481741; PubMed Central PMCID: PMC6722235. 9. Neoptolemos JP, Kerr DJ, Beger H, Link K, Pederzoli P, Bassi C, Dervenis C, Fernandez-Cruz L, Laçaine F, Friess H, Büchler M. ESPAC-1 trial progress report: the European randomized adjuvant study comparing radiochemotherapy, 6 months chemotherapy and combination therapy versus observation in pancreatic cancer. Digestion. 1997;58(6):570-577. doi:10.1159/000201503. 10. Klinkenbijl JH, Jeekel J, Sahmoud T, van Pel R, Couvreur ML, Veenhof CH, Arnaud JP, Gonzalez DG, de Wit LT, Hennipman A, Wils J. Adjuvant radiotherapy and 5-fluorouracil after curative resection of cancer of the pancreas and periampullary region: phase III trial of the EORTC gastrointestinal tract cancer cooperative group. Ann Surg. 1999;230(6):776784. doi:10.1097/00000658-199912000-00006. 11. Nassour I, Hynan LS, Christie A, Minter RM, Yopp AC, Choti MA, Mansour JC, Porembka MR, Wang SC. Association of Adjuvant Therapy with Improved Survival in Ampullary Cancer: A National Cohort Study. J Gastrointest Surg. 2018 Apr;22(4):695702. doi: 10.1007/s11605-017-3624-6. Epub 2017 Nov 10. PMID: 29127604; PMCID: PMC5890432. 12. Neoptolemos JP, Moore MJ, Cox TF, Valle JW, Palmer DH, McDonald AC, Carter R, Tebbutt NC, Dervenis C, Smith D, Glimelius B, Charnley RM, Lacaine F, Scarfe AG, Middleton MR, Anthoney A, Ghaneh P, Halloran CM, Lerch MM, Oláh A, Rawcliffe CL, Verbeke CS, Campbell F, Büchler MW; European Study Group for Pancreatic Cancer. Effect of adjuvant chemotherapy with fluorouracil plus folinic acid or gemcitabine vs observation on survival in patients with resected periampullary adenocarcinoma: the ESPAC-3 periampullary cancer randomized trial. JAMA. 2012 Jul 11;308(2):147-56. doi: 10.1001/jama.2012.7352. Erratum in: JAMA. 2012 Nov 14;308(18):1861. PubMed PMID: 22782416. 13. Neoptolemos JP, Moore MJ, Cox TF, Valle JW, Palmer DH, Mcdonald A, Carter R, Tebbutt NC, Dervenis C, Smith D, Glimelius B, Coxon FY, Lacaine F, Middleton MR, Ghaneh P, Bassi C, Halloran C, Olah A, Rawcliffe CL, Büchler MW. Ampullary cancer ESPAC-3 (v2) trial: a multicenter, international, openlabel, randomized controlled phase III trial of adjuvant chemotherapy versus observation in patients with adenocarcinoma of the ampulla of Vater. J Clin Oncol. 2016;29:LBA4006. 14. Jin Z, Hartgers ML, Sanhueza CT, Shubert CR, Alberts SR, Truty MJ, Muppa P, Nagorney DM, Smyrk TC, Hassan M, Mahipal A. Prognostic factors and benefits of adjuvant therapy after pancreatoduodenectomy for ampullary adenocarcinoma: Mayo Clinic experience. Eur J Surg Oncol. 2018 May;44(5):677-683. doi: 10.1016/j.ejso.2018.02.008. Epub 2018 Feb 16. PMID: 29506768. 15. Al-Jumayli M, Batool A, Middiniti A, Saeed A, Sun W, Al-Rajabi R, Baranda J, Kumer S, Schmitt T, Chidharla A, Kasi A. Clinical Outcome of Ampullary Carcinoma: Single Cancer Center Experience. J Oncol. 2019 May 2;2019:3293509. doi: 10.1155/2019/3293509. PMID: 31186632; PMCID: PMC6521487. 16. Ecker BL, Vollmer CM Jr, Behrman SW, Allegrini V, Aversa J, Ball CG, Barrows CE, Berger AC, Cagigas MN, Christein JD, Dixon E, Fisher WE, Freedman-Weiss M, Guzman-Pruneda F, Hollis RH, House MG, Kent TS, Kowalsky SJ, Malleo G, Salem RR, Salvia R, Schmidt CR, Seykora TF, Zheng R, Zureikat AH, Dickson PV. Role of Adjuvant Multimodality Therapy After Curative-Intent Resection of Ampullary Carcinoma. JAMA Surg. 2019 Aug 1;154(8):706-714. doi: 10.1001/jamasurg.2019.1170. PMID: 31141112; PMCID: PMC6547142. 17. Kwon J, Kim BH, Kim K, Chie EK, Ha SW. Survival Benefit of Adjuvant Chemoradiotherapy in Patients With Ampulla of Vater Cancer: A Systematic Review and Meta-analysis. Ann Surg. 2015 Jul;262(1):47-52. doi: УДК 13058 ГРНТИ 76.29 10.1097/SLA.0000000000001182. Review. PubMed PMID: 25775067. 18. Rasulov RI, Zemko MV, Ushakova IV, Songolov GI. Ductal cancer of pancreatic head neoadjuvant treatment: close and results. Practical oncology. 2018; 19(4): 408-418. doi: 10.31917/1903408. 19. Hoffman JP, Cooper HS, Young NA, Pendurthi TK. Preoperative chemotherapy of chemoradiotherapy for the treatment of adenocarcinoma of the pancreas and ampulla of Vater. J Hepatobiliary Pancreat Surg. 1998;5(3):251-4. Review. PubMed PMID: 9880771. 20. Palta M, Patel P, Broadwater G, Willett C, Pepek J, Tyler D, Zafar SY, Uronis H, Hurwitz H, White R, Czito B. Carcinoma of the ampulla of Vater: patterns of failure following resection and benefit of chemoradiotherapy. Ann Surg Oncol. 2012 May;19(5):1535-40. doi: 10.1245/s10434-011-2117-1. Epub 2011 Nov 2. PubMed PMID: 22045467; PubMed Central PMCID: PMC4155936. 21. Willett CG, Lewandrowski K, Warshaw AL, Efird J, Compton CC. Resection margins in carcinoma of the head of the pancreas. Implications for radiation therapy. Ann Surg. 1993 Feb;217(2):144-8. doi: 10.1097/00000658-199302000-00008. PMID: 8094952; PMCID: PMC1242753.