Abstract:
Objective To explore the clinical efficacy and toxicity of intensity modulated radiotherapy (IMRT) combined with oral capecitabine concurrent chemotherapy and HIFU for elderly patients with nonoperatable pancreatic cancer.
Methods Total 60 elderly patients with non-operatable pancreatic cancer were randomly divided into two group, 30 patients in control group received concurrent radiochemotherapy (intensity modulated radiation therapy (IMRT) with 6 MV X-ray and concurrently oral capecitabine (800-1 000 mg/m2, bid, d1-14, 21 days/cycle, concurrent chemotherapy for two cycles, consolidate chemotherapy for 2-4cycles)), and 30 patients in observation group received same concurrent radiochemotherapy and HIFU carried out concurrently with IMRT (5 days/week, 4-6 weeks).
Results There was significant difference of pain relief score in both control and observation group before and after treatment (P=0.001, P < 0.0001); the degree of pain releif in the observation group was more than that in the control group (P=0.0162). The difference of the short-term effects between two groups was statistical (Z=-2.159, P=0.031). The over survival, progression-free survival, failure patterns and adverse effects, such as myelosuppression, radiation-induced liver disease, radiationinduced gastrointestinal disease and radiation-induced kidney disease, were not statistically different between two groups (P>0.05).
Conclusion IMRT combined with capecitabine concurrent chemotherapy and HIFU for elderly patients with non-operatable pancreatic cancer are safe and effective in relieving pain and improving the quality of life, but there isn't advantage in longer overall survival or longer progression-free survival.
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