Conversion Therapy for Locally Advanced Pancreatic Cancer: A Case Series and Literature Review

Abstract

Patients with locally advanced pancreatic cancer account for a large proportion of patients with pancreatic cancer. According to the National Comprehensive Cancer Network guidelines, the patients with good performance status can undergo chemotherapy or chemoradiotherapy. However, a growing number of clinical studies suggested that aggressive surgical treatment after chemotherapy may lead to longer survival. In this case series, we report the effect of conversion therapy in four patients with locally advanced pancreatic cancer who visited Zhejiang Provincial People’s Hospital from January 2015 to October 2020. The clinical evaluation and prognosis of these patients after conversion therapy were analyzed and discussed in conjunction with relevant literature. The median overall survival time of the patients was 21.5 months. One patient who underwent surgery after chemotherapy achieved R0 resection. Another patient gave up the opportunity of surgery in the process of conversion therapy, but has been living with the tumor since. Taken together, the patients with locally advanced pancreatic cancer can benefit from conversion therapy in achieving R0 resection or longterm survival if surgery is not implemented.