Background: Despite the improvement in therapies, pancreatic cancer represents one of the most cancer-related deaths. In our hypothesis, we propose that Hyperthermic Intraperitoneal Chemotherapy with gemcitabine after pancreatic cytoreductive surgery could reduce tumor progression by reducing residual neoplastic volume and residual pancreatic cancer stem cells. Materials and methods: A randomized trial involving 42 patients. All patients were diagnosed with pancreatic ductal adenocarcinoma. Group I: R0 resection. Group II. R0 resection and HIPEC with gemcitabine (120 mg/m2for 30 min). Effectiveness was measured with analysis of overall survival, disease-free survival, distant recurrence, locoregional recurrence, and measuring of pancreatic cancer stem cells (EpCAM+CXCR4+CD133+). Results: From 2017 to 2023, 63 patients were recruited for our clinical trial; 21 patients were included in each group, and 21 were excluded. Locoregional recurrence,p-value: 0.022, was lower in the experimental group. There were no significant differences between the two groups in hospital mortality, perioperative complications, or hospital costs. We found a significant decrease in pancreatic cancer stem cells in patients in the experimental group after treatment,p-value of 0.018. Conclusions: The use of HIPEC with gemcitabine after surgery in patients with resectable pancreatic ductal adenocarcinoma reduces locoregional recurrence and may be associated with a significant decrease in pancreatic cancer stem cells.
背景：尽管治疗方法有所改进，胰腺癌仍是导致癌症相关死亡的主要原因之一。基于我们的假设，胰腺减瘤术后采用吉西他滨进行腹腔热灌注化疗，可通过减少残留肿瘤体积及胰腺癌干细胞数量来抑制肿瘤进展。 材料与方法：本研究为一项纳入42例患者的随机试验。所有患者均确诊为胰腺导管腺癌。第一组接受R0切除术；第二组在R0切除术后接受吉西他滨腹腔热灌注化疗（剂量120 mg/m²，持续30分钟）。通过分析总生存期、无病生存期、远处复发率、局部区域复发率及胰腺癌干细胞（EpCAM+CXCR4+CD133+）数量评估疗效。 结果：2017年至2023年间，共招募63例患者参与临床试验；每组纳入21例，排除21例。实验组的局部区域复发率显著降低（p值为0.022）。两组在住院死亡率、围手术期并发症及住院费用方面无显著差异。实验组患者治疗后胰腺癌干细胞数量显著减少（p值为0.018）。 结论：对于可切除胰腺导管腺癌患者，术后采用吉西他滨腹腔热灌注化疗可降低局部区域复发率，并可能与胰腺癌干细胞的显著减少相关。
肿瘤(癌症)患者之家