Combined modality treatment for patients with locally advanced pancreatic adenocarcinoma.
BACKGROUND
Radiofrequency ablation (RFA) is an emerging treatment for patients with locally advanced pancreatic carcinoma, and can be combined with radiochemotherapy and intra-arterial plus systemic chemotherapy.


METHODS
This observational study compared two groups of patients with locally advanced pancreatic carcinoma treated with either primary RFA (group 1) or RFA following any other primary treatment (group 2).


RESULTS
Between February 2007 and May 2010, 107 consecutive patients were treated with RFA. There were 47 patients in group 1 and 60 in group 2. Median overall survival was 25·6 months. Median overall survival was significantly shorter in group 1 than in group 2 (14·7 versus 25·6 months; P = 0·004) Patients treated with RFA, radiochemotherapy and intra-arterial plus systemic chemotherapy (triple-approach strategy) had a median overall survival of 34·0 months.


CONCLUSIONS
RFA after alternative primary treatment was associated with prolonged survival. This was further extended by use of a triple-approach strategy in selected patients. Further evaluation of this approach seems warranted.
Oncological Department, Carrara Hospital, Carrara, Italy. maurizio.cantore@usl1.toscana.it
M
M
Cantore
R
R
Girelli
A
A
Mambrini
I
I
Frigerio
G
G
Boz
R
R
Salvia
A
A
Giardino
M
M
Orlandi
A
A
Auriemma
C
C
Bassi
D000230:Adenocarcinoma / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D059248:Chemoradiotherapy / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000628:therapy*; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome; D000093542:Gemcitabine
D003841:Deoxycytidine; D015251:Epirubicin; D002945:Cisplatin; D000093542:Gemcitabine