The effect of neoadjuvant chemoradiation therapy in resectable pancreatic cancer was independent of intratumoral vascularization
Abstract Aim Contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) has promising potential in the diagnosis of pancreatic tumors, assessment of fibrosis, and prediction of chemotherapy efficacy. We hypothesize that radiation therapy might reduce variations in chemotherapeutic efficacy caused by...
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BMC
2025-07-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-025-04108-2 |
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| author | Tomomi Yasue Reiko Ashida Ryoji Takada Kenji Ikezawa Kazuyoshi Ohkawa Shigenori Nagata Teruki Teshima Hirofumi Akita Hidenori Takahashi Yuichiro Doki Hidetoshi Eguchi |
| author_facet | Tomomi Yasue Reiko Ashida Ryoji Takada Kenji Ikezawa Kazuyoshi Ohkawa Shigenori Nagata Teruki Teshima Hirofumi Akita Hidenori Takahashi Yuichiro Doki Hidetoshi Eguchi |
| author_sort | Tomomi Yasue |
| collection | DOAJ |
| description | Abstract Aim Contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) has promising potential in the diagnosis of pancreatic tumors, assessment of fibrosis, and prediction of chemotherapy efficacy. We hypothesize that radiation therapy might reduce variations in chemotherapeutic efficacy caused by fibrosis-induced blood flow disparities, as we explored the relationship between CH-EUS patterns and the efficacy of neoadjuvant chemoradiotherapy (NACRT) in resectable pancreatic cancer (PC). Methods Patients with resectable PC who underwent CH-EUS followed by NACRT were retrospectively analyzed. The CH-EUS enhancement pattern was evaluated in the vascular and perfusion phases and classified according to vascularity: Group A, hypovascular in both phases; Group B, isovascular and hypovascular in the vascular and perfusion phases, respectively; and Group C, isovascular in both phases. The relationships between the CH-EUS vascular pattern and the histological response according to the Evans classification to NACRT, recurrence-free survival (RFS) and overall survival (OS) were evaluated. Results Of the 48 enrolled patients, 31, 11, and 6 were classified into Groups A, B, and C, respectively. There was no significant difference in histopathological differentiation (p = 0.314) or the efficacy of NACRT (p = 0.282) among the groups. In addition, there was no significant difference between the groups in terms of median RFS or OS, although it was longer than previously reported. Conclusion The histopathological efficacy of NACRT for resectable PC did not differ significantly on the basis of enhancement pattern observed on CH-EUS. NACRT may provide additional therapeutic benefit independent of blood flow considerations. |
| format | Article |
| id | doaj-art-4da3a435e3eb4a63a426a7d795c96f77 |
| institution | Kabale University |
| issn | 1471-230X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj-art-4da3a435e3eb4a63a426a7d795c96f772025-08-20T03:42:57ZengBMCBMC Gastroenterology1471-230X2025-07-0125111110.1186/s12876-025-04108-2The effect of neoadjuvant chemoradiation therapy in resectable pancreatic cancer was independent of intratumoral vascularizationTomomi Yasue0Reiko Ashida1Ryoji Takada2Kenji Ikezawa3Kazuyoshi Ohkawa4Shigenori Nagata5Teruki Teshima6Hirofumi Akita7Hidenori Takahashi8Yuichiro Doki9Hidetoshi Eguchi10Department of Clinical Laboratory, Osaka Habikino Medical CenterSecond Department of Internal Medicine, Wakayama Medical UniversityDepartment of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer InstituteDepartment of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer InstituteDepartment of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer InstituteDepartment of Diagnostic Pathology and Cytology, Osaka International Cancer InstituteDepartment of Radiation Oncology, Nozaki Tokushukai HospitalDepartment of Gastroenterological Surgery, The University of Osaka Graduate School of MedicineDepartment of Gastroenterological Surgery, The University of Osaka Graduate School of MedicineDepartment of Gastroenterological Surgery, The University of Osaka Graduate School of MedicineDepartment of Gastroenterological Surgery, The University of Osaka Graduate School of MedicineAbstract Aim Contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) has promising potential in the diagnosis of pancreatic tumors, assessment of fibrosis, and prediction of chemotherapy efficacy. We hypothesize that radiation therapy might reduce variations in chemotherapeutic efficacy caused by fibrosis-induced blood flow disparities, as we explored the relationship between CH-EUS patterns and the efficacy of neoadjuvant chemoradiotherapy (NACRT) in resectable pancreatic cancer (PC). Methods Patients with resectable PC who underwent CH-EUS followed by NACRT were retrospectively analyzed. The CH-EUS enhancement pattern was evaluated in the vascular and perfusion phases and classified according to vascularity: Group A, hypovascular in both phases; Group B, isovascular and hypovascular in the vascular and perfusion phases, respectively; and Group C, isovascular in both phases. The relationships between the CH-EUS vascular pattern and the histological response according to the Evans classification to NACRT, recurrence-free survival (RFS) and overall survival (OS) were evaluated. Results Of the 48 enrolled patients, 31, 11, and 6 were classified into Groups A, B, and C, respectively. There was no significant difference in histopathological differentiation (p = 0.314) or the efficacy of NACRT (p = 0.282) among the groups. In addition, there was no significant difference between the groups in terms of median RFS or OS, although it was longer than previously reported. Conclusion The histopathological efficacy of NACRT for resectable PC did not differ significantly on the basis of enhancement pattern observed on CH-EUS. NACRT may provide additional therapeutic benefit independent of blood flow considerations.https://doi.org/10.1186/s12876-025-04108-2ChemoradiationCH-EUSEUSNeoadjuvant therapyPancreatic cancer |
| spellingShingle | Tomomi Yasue Reiko Ashida Ryoji Takada Kenji Ikezawa Kazuyoshi Ohkawa Shigenori Nagata Teruki Teshima Hirofumi Akita Hidenori Takahashi Yuichiro Doki Hidetoshi Eguchi The effect of neoadjuvant chemoradiation therapy in resectable pancreatic cancer was independent of intratumoral vascularization BMC Gastroenterology Chemoradiation CH-EUS EUS Neoadjuvant therapy Pancreatic cancer |
| title | The effect of neoadjuvant chemoradiation therapy in resectable pancreatic cancer was independent of intratumoral vascularization |
| title_full | The effect of neoadjuvant chemoradiation therapy in resectable pancreatic cancer was independent of intratumoral vascularization |
| title_fullStr | The effect of neoadjuvant chemoradiation therapy in resectable pancreatic cancer was independent of intratumoral vascularization |
| title_full_unstemmed | The effect of neoadjuvant chemoradiation therapy in resectable pancreatic cancer was independent of intratumoral vascularization |
| title_short | The effect of neoadjuvant chemoradiation therapy in resectable pancreatic cancer was independent of intratumoral vascularization |
| title_sort | effect of neoadjuvant chemoradiation therapy in resectable pancreatic cancer was independent of intratumoral vascularization |
| topic | Chemoradiation CH-EUS EUS Neoadjuvant therapy Pancreatic cancer |
| url | https://doi.org/10.1186/s12876-025-04108-2 |
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