| Objective: The purpose of this study was to investigate the efficacy and prognosis of conversion therapy in patients with initially unresectable pancreatic cancer,in order to provide a valuable treatment plan for patients with unresectable pancreatic cancer.Methods: We retrospectively analyzed the data of patients with locally advanced or advanced pancreatic cancer who admitted to Zhejiang Province People’s Hospital during the period from January 2015 to July 2021.Among them,25 patients received conversion therapy,39 patients received chemotherapy alone,and 19 patients received surgery directly after initial diagnosis.Patients who received conversion therapy were guided by Multi-disciplinary Treatment（MDT）,and then selected a specific chemotherapy regimen for conversion chemotherapy.During the process of conversion chemotherapy,the patients were regularly evaluated for indications for radical surgery,and surgical resection was performed after meeting the surgical conditions.Chose an adjuvant therapy option if need after surgery.The study endpoints were R0 resection rate,overall survival（OS）and progression-free survival（PFS）,and the incidence of adverse reactions.Statistical analysis was performed using IBM SPSS 25.0 software,Kaplan-Meier method and Logrank test were used for survival analysis,and Cox proportional hazards model was used to analyze prognostic factors.Results:One-Way ANOVA was used to test the difference of OS and PFS of pancreatic cancer patients in the three groups（P=0.0098,P=0.0004）,the difference was statistically significant.Then Log-rank method was used to test the difference of OS and PFS in each two groups of pancreatic cancer patients.The results showed that the median OS of pancreatic cancer patients in the conversion therapy group was longer than that in the chemotherapy-only group（P=0.001）and the surgery group（P=0.018）,and the median PFS was also longer than the chemotherapy-only group（P=0.038）and the surgery group（P<0.001）.The 1-year,2-year and 3-year survival rates of patients in the conversion therapy group were 80%,24% and 8%,respectively.The R0 resection rate was 84%,and the adverse reactions were within the controllable range.Conclusion: Our study suggests that conversion therapy can prolong OS and PFS of inoperable pancreatic cancer patients.Age and CA199 decline after conversion therapy are independent factors affecting OS.In addition,conversion therapy significantly prolonged OS in pancreatic cancer patients with distant metastasis. |
