Evidence map›Paper›PMID 41029810›Full record

ArticleWorld journal of surgical oncology2025

Safety and pathological impact of resection after high-dose PBT for locally advanced pancreatic cancer.

Osamu Shimomura, Haruko Numajiri, Shinji Hashimoto, Yoshihiro Miyazaki, Manami Doi, Hiromitsu Nakahashi, Kazuhiro Takahashi, Yuichi Hiroshima, Naoyuki Hasegawa, Masato Endo and 10 more

Abstract read
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In one paragraph

Article in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Osamu Shimomura *Department of Gastrointestinal-Hepato-Biliary-Pancreatic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan. oshimomura@md.tsukuba.ac.jp.
Haruko Numajiri *Department of Radiation Oncology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Shinji HashimotoDepartment of Gastrointestinal-Hepato-Biliary-Pancreatic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Yoshihiro MiyazakiDepartment of Gastrointestinal-Hepato-Biliary-Pancreatic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Manami DoiDepartment of Gastrointestinal-Hepato-Biliary-Pancreatic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Hiromitsu NakahashiDepartment of Gastrointestinal-Hepato-Biliary-Pancreatic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Kazuhiro TakahashiDepartment of Gastrointestinal-Hepato-Biliary-Pancreatic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Yuichi HiroshimaDepartment of Radiation Oncology, Ibaraki Prefectural Central Hospital, Ibaraki Cancer Center, Kasama, Ibaraki, Japan.
Naoyuki HasegawaDepartment of Gastroenterology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Masato EndoDepartment of Gastroenterology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Yusuke NiisatoDepartment of Gastroenterology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Yuya HagiwaraDepartment of Gastroenterology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Yoshiyuki YamamotoDepartment of Gastroenterology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Takeshi YamadaDepartment of Gastroenterology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Noriaki SakamotoDepartment of Pathology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Daisuke MatsubaraDepartment of Pathology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Bryan J MathisDepartment of Cardiovascular Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Kiichiro TsuchiyaDepartment of Gastroenterology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Hideyuki SakuraiDepartment of Radiation Oncology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Tatsuya OdaDepartment of Gastrointestinal-Hepato-Biliary-Pancreatic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA multidisciplinary approach is essential for treating lethal pancreatic cancer. Proton beam therapy (PBT), with its potential for dose escalation, shows promising effect for the local tumor, but the safety of subsequent resection and its pathological impact remain uncertain.

methodsA retrospective single-center analysis was conducted on patients with locally advanced pancreatic cancer who underwent multidisciplinary treatment, including PBT, chemotherapy and hyperthermia (January 2014 to December 2022). PBT target dose was 67.5 Gy concurrently gemcitabine infusion and local hyperthermia was applied 1 h after gemcitabine infusion. The standard chemo regimens (such as gemcitabine with nab-paclitaxel or FOLFIRINOX) followed triple-modal treatment. Surgical complications, pathological assessment and survival were analyzed in resected cases.

resultsAmong 133 patients treated with PBT, 110 underwent triple-modal treatment combining PBT, hyperthermia, and chemotherapy. Ultimately, 11 patients underwent tumor resection after a median preoperative treatment duration of 210 days. Surgical procedures included five pancreaticoduodenectomies and six distal pancreatectomies. Three patients experienced complications of Clavien-Dindo grade 3 or higher (2; delayed gastric empty, 1; pancreatic fistula), but no mortality occurred. Histological evaluations revealed three cases of Grade 4 (27%, pathological complete response), four of Grade 3, three of Grade 2, and one of Grade 1. R0 resection was achieved in 10 cases.

conclusionsSurgical resection following high-dose PBT can be safely performed under strict selection criteria and demonstrates strong pathological disease control of the primary tumor. This multidisciplinary approach may offer improved outcomes for locally advanced pancreatic cancer.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsHyperthermia, InducedPancreatectomyPancreatic NeoplasmsPancreaticoduodenectomyAdultAgedCombined Modality TherapyDeoxycytidineFemaleFollow-Up StudiesGemcitabineHumansMaleMiddle AgedPrognosisDeoxycytidineGemcitabineComplicationsHyperthermiaLocally advanced pancreatic cancerMultidisciplinaryPathological findingsProton beam therapy

Identifiers

PMID41029810
PMCPMC12486620

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.