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

World J Clin Oncol. 2021 Nov 24;12(11):1064-1071. doi: 10.5306/wjco.v12.i11.1064.

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 electro-hyperthermia (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-free survival and local tumor control with comparable toxicity.

Keywords: Locally advanced pancreatic cancer; Modulated electro-hyperthermia; Survival; Tumor response.