Pancreatic Exocrine Function Following Radiation Therapy In Patients With Pancreatic Cancer

Backgroud:Pancreatic cancer(PC) is the seventh most frequent cause of cancer death all over the world.More than 80% of patients with PC are not eligible for pancreatic resection, while the majority of these tumors are diagnosed at advanced stage. Radiation therapy has become an important treatment of locally advanced pancreatic cancer.Pancreatic exocrine function following radiation therapy in patients with pancreatic cancer is still unknown. Objective: The aim of this study was to assess pancreatic exocrine function(PEF) following radiation therapy in patients with pancreatic cancer(PC). Methods: Thirty eligible patients with pancreatic cancer and 10 healthy volunteers were enrolled in this study.We evaluated PEF by fecal elastase 1(FE1) for all patients and controls before and after radiation therapy.Results: The FE1 level in control group was 356.01±169.72 ug/g,FE1 level was 164.50±143.28 ug/g before radiotherapy in patients with pancreatic cancer, after radiotherapy FE1 level 77.35±52.85ug/g, paired sample T test P <0.001, FE1 level decreased significantly during radiation therapy in patients with pancreatic cancer. The incidence of pancreatic exocrine insufficiency(exocrine pancreatic insufficiency, EPI) pre and after radiotherapy in patients with PC were 66.7% and 100%,respectively.The incidence of mild to moderate EPI and serve EPI before radiotherapy in patients group were 16.7% and 50.0%, respectively. After radiotherapy, the rate of mild to moderate and severe pancreatic exocrine insufficiency were 26.7%, 73.3% respectively. Conclusion: radiation therapy reduce pancreatic exocrine function in patients with pancreatic cancer, the incidence of severe EPI rate was 73.3% post radiation therapy in patients with PC.It is recommended to monitor pancreatic exocrine function in patients with pancreatic cancer, which could guide patients receive pancreatic enzyme replacement therapy in time.