Feasibility and efficacy of cell-free and concentrate ascites reinfusion therapy (CART) for advanced pancreatic cancer patients with massive malignant ascites

IF 2.8 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pancreatology Pub Date : 2024-09-01 DOI:10.1016/j.pan.2024.07.013

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Abstract

Background

The management of malignant ascites is critical for treating patients with advanced pancreatic cancer. The purpose of this study was to assess the safety of cell-free and concentrated ascites reinfusion therapy (CART) and its impact on the prognosis of patients with advanced pancreatic cancer who have massive malignant ascites.

Methods

This study analyzed 47 procedures in 29 patients who underwent CART for ascites caused by pancreatic cancer between 2015 and 2022. Among them, 7 patients who received chemotherapy following CART were classified as the chemotherapy group, while 22 patients without chemotherapy after CART were classified as the palliative care group.

Results

Among the 47 procedures, adverse events (AEs) were observed in 9 procedures (19 %). Grade 2 adverse events were observed only in one procedure, manifested as fever. There were no grade 3 or 4 AEs, nor were there any treatment-related deaths. The median survival time was 4.0 months in the chemotherapy group and 0.7 months in the palliative care group (p = 0.004). The albumin level in the chemotherapy group was significantly higher than that in the palliative care group.

Conclusion

CART is feasible and might be the optimal option to enable prolonged use of chemotherapy to improve the prognosis for late-stage pancreatic cancer patients.

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无细胞浓缩腹水再灌注疗法（CART）治疗晚期胰腺癌患者大量恶性腹水的可行性和疗效。

背景：恶性腹水的处理对于晚期胰腺癌患者的治疗至关重要。本研究旨在评估无细胞和浓缩腹水再灌注疗法（CART）的安全性及其对大量恶性腹水的晚期胰腺癌患者预后的影响：本研究分析了2015年至2022年间因胰腺癌导致腹水而接受CART治疗的29名患者的47个治疗过程。其中，CART术后接受化疗的7例患者被划分为化疗组，CART术后未接受化疗的22例患者被划分为姑息治疗组：在47例手术中，9例（19%）发生了不良事件（AEs）。只有一项手术出现了二级不良反应，表现为发热。没有出现 3 级或 4 级不良反应，也没有与治疗相关的死亡病例。化疗组的中位生存时间为 4.0 个月，姑息治疗组为 0.7 个月（P = 0.004）。化疗组的白蛋白水平明显高于姑息治疗组：CART是可行的，可能是延长化疗时间以改善晚期胰腺癌患者预后的最佳选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pancreatology 医学-胃肠肝病学

CiteScore

7.20

自引率

5.60%

发文量

194

审稿时长

44 days

期刊介绍： Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.