Patients with advanced pancreatic cancer and ascites may benefit from regional radiofrequency thermotherapy (RFTT) in conjunction with systemic and intraperitoneal (IP) chemotherapy, according to a study published in the Journal of Global Oncology.1
Evidence from prior studies suggests that direct delivery of cytotoxic drugs to the tumor-harboring compartment may be more effective in increasing tumor response rates compared with systemic administration, and it has been demonstrated that hyperthermia can change the characteristics of cancer cells, making them more susceptible to treatment.
This study retrospectively analyzed the outcomes of 29 chemotherapy-naïve patients with locally advanced or metastatic pancreatic carcinoma with malignant ascites. Patients received hyperthermia treatment to their upper abdomens twice a week from days 1 to 21. Patients also received intraperitoneal cisplatin 30 mg/m2 and gemcitabine 800 to 1000 mg/m2 intravenously on days 1, 8, and 15 every 4 weeks. Follow-up was completed every 2 cycles.
Thirteen patients (44.8%) experienced partial responses; no patients experienced complete response; the overall objective response rate was 44.8%.
The disease control rate was 70%.
The mean progression-free survival for the study was 119+61 days; the mean overall survival (OS) was 195+98 days.
The most frequently reported adverse events were grade 2 nausea/vomiting (10.3%), fatigue (13.5%), and grade 3 to 4 thrombocytopenia (13.8%) and neutropenia (17.2%).
Grade 1 to 2 abdominal pain was reported post-intraperitoneal administration of cisplatin, but improved upon increasing the normal saline volume in the infusion.
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The authors concluded that “this treatment approach offered a remarkable disease control rate and respectable OS in this notably refractory patient group.”
- Fan YF, Qin Y, Li DG, Kerr D. Retrospective clinical study of advanced pancreatic cancer treated with chemotherapy and abdominal hyperthermia. J Glob Oncol. 2017 Jul 25. doi: 10.1200/JGO.2017.009985 [Epub ahead of print]