Neoadjuvant therapy for borderline resectable or unresectable pancreatic cancer

No standard neoadjuvant treatment regimen exists for borderline respectable pancreatic cancer. At first, We retrospectively examined S-1 with concurrent radiation therapy (S-1/rad) or Gemcitabine plus S-1 (GS) or Gemcitabine alone (Gem) for borderline resectable or locally advanced pancreatic cancer. Response rate in S-1/rad was higher than that in GS or Gem. However, time to response, overall survival and conversion rate to surgery was almost even between S-1/rad and GS. Secondary we compared neoadjuvant group and surgery-first group in patients with borderline resectable pancreatic cancer. Higher R0 resection rate was achieved in neoadjuvant group (91% vs 67%). The estimated survival rate of neoadjuvant group was significantly better than that of surgery-first group. Both of S-1/rad and GS are promising neoadjuvant therapy for borderline resectable pancreatic cancer. (author)