Published in:
Open Access
01-12-2013 | Case report
Neoadjuvant chemoradiation therapy for borderline pancreatic adenocarcinoma: report of two cases
Authors:
José Galindo, Mauricio Gabrielli, Juan Francisco Guerra, Juan Carlos Cassina, Marcelo Garrido, Nicolás Jarufe, Yerko Borghero, Jorge Madrid, Pablo Zoroquiain, Juan Carlos Roa, Jorge Martínez
Published in:
World Journal of Surgical Oncology
|
Issue 1/2013
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Abstract
Pancreatic cancer remains as one of the most aggressive human neoplasms, with overall poor survival rates. Radical surgery of the primary lesion is the best option for treatment. Borderline resectable pancreatic tumors (BRPT), defined as partial involvement of peripancreatic vasculature, may benefit from neoadjuvant therapy. We report on the first two BRPT cases treated with neoadjuvant chemoradiation at our institution. Preoperative CT and MRI demonstrated pancreatic tumors encasing the porto-mesenteric confluence suggestive of BRPT. Patients received neoadjuvant chemotherapy (gemcitabine/cisplatin), followed by radiochemotherapy. After treatment, follow-up images demonstrated tumor downsize, allowing for the tumors to be considered then as resectable. They underwent partial pancreatoduodenectomies (Whipple procedure). In case 1, histopathology revealed a complete, margin-free resection, whereas in case 2 there was a complete pathological response, with no evidence of residual tumor. According to the literature, our initial experience using neoadjuvant chemoradiotherapy on BRPT allowed us to downsize the tumor and, subsequently, to perform a curative surgery.