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Modulated electro-hyperthermia in stage III and IV pancreatic cancer: Results of an observational study on 158 patients

Abstract
BACKGROUND
An increasing number of studies report the beneficial effects of regional hyperthermia in association with chemotherapy (CHT) and radiotherapy for the treatment of pancreatic cancer; in particular, the use of modulated electrohyperthermia (mEHT) results in increased survival and tumor response.

AIM
To compare outcomes of CHT alone or in association with mEHT for the treatment of stage III and IV pancreatic cancer. METHODS
This was an observational retrospective study; data were collected for patients with stage III-IV pancreatic cancer that were treated with CHT alone or in combination with mEHT from 2003 to 2019. A total of 158 patients were included in the study out 270 patients screened in four Italian hospitals; 58 (37%) of these received CHT + mEHT and 100 (63%) CHT. CHT was mainly gemcitabine-based
regimens in both groups.

RESULTS
Overall (19.5 mo vs 11.02 mo, P < 0.001) and progression-free (12 mo vs 3 mo, P < 0.001) survival were better for the CHT + mEHT group compared to the CHT group. The association of mEHT resulted also in an improvement of tumor response with disease control rate 95% vs 58% (P < 0.001) at 3 mo. Toxicity was comparable in the two study groups, and mEHT related adverse events were
limited in 8 patients presenting G1-2 skin burns.

CONCLUSION
The addition of mEHT to systemic CHT improved overall and progression-freesurvival and local tumor control with comparable toxicity.