title: The Role of Pancreatic Enzyme Replacement Therapy in Unresectable Pancreatic Cancer: A Prospective Cohort Study.
abstract: Although patients with pancreatic cancer (PC) are prone to exocrine pancreatic insufficiency, there are little evidence about pancreatic enzyme replacement therapy (PERT) in patients with PC, especially those receiving chemotherapy.
  
  
  
  This is a prospective consecutive observational study of PERT in patients with unresectable PC. We prospectively enrolled patients receiving chemotherapy for unresectable PC from April 2012 to February 2014 and prescribed oral pancrelipase of 48,000 lipase units per meal (pancrelipase group). N-benzoyl-tryrosyl para-aminobenzoic acid test was performed at baseline. Patients receiving chemotherapy before April 2012 were retrospectively studied as a historical cohort. Data on the nutritional markers at baseline and 16 weeks were extracted, and serial changes, defined as the ratio of markers at 16 weeks/baseline, were compared between 2 groups.
  
  
  
  A total of 91 patients (46 in the pancrelipase group and 45 in the historical cohort) were analyzed. N-benzoyl-tryrosyl para-aminobenzoic acid test was low in 94% of the pancrelipase group. Serial change in the pancrelipase group versus historical cohort was 1.01 versus 0.95 in body mass index (P < 0.001) and 1.03 versus 0.97 in serum albumin (P = 0.131).
  
  
  
  The rate of exocrine pancreatic insufficiency in unresectable PC was high, and PERT can potentially improve the nutritional status during chemotherapy.
authors.affiliation: From the *Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo; and †Department of Gastroenterology, Tokyo Takanawa Hospital, Tokyo, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Saito
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Nakai
authors.forename: Kei
authors.initials: K
authors.lastname: Saito
authors.forename: Gyotane
authors.initials: G
authors.lastname: Umefune
authors.forename: Dai
authors.initials: D
authors.lastname: Akiyama
authors.forename: Takeo
authors.initials: T
authors.lastname: Watanabe
authors.forename: Kaoru
authors.initials: K
authors.lastname: Takagi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hamada
authors.forename: Naminatsu
authors.initials: N
authors.lastname: Takahara
authors.forename: Rie
authors.initials: R
authors.lastname: Uchino
authors.forename: Suguru
authors.initials: S
authors.lastname: Mizuno
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kogure
authors.forename: Saburo
authors.initials: S
authors.lastname: Matsubara
authors.forename: Natsuyo
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Minoru
authors.initials: M
authors.lastname: Tada
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056947:Enzyme Replacement Therapy / Q000379:methods*; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010179:Pancreas / Q000187:drug effects* / Q000201:enzymology / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D020799:Pancrelipase / Q000008:administration & dosage / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D011446:Prospective Studies
chemical_list: D005765:Gastrointestinal Agents; D020799:Pancrelipase