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  • br N H Mohamed A E Mahrous Chemical

    2019-10-14


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    Contents lists available at ScienceDirect
    Medical Hypotheses
    journal homepage: www.elsevier.com/locate/mehy
    A new proposal of utilizing intraoperative PSB 1115 radiation therapy on the T surface of liver to prevent postoperative liver metastasis of pancreatic cancer
    Yiting Dongc,a, Zikuan Songb, Yuling Luoa, Xuelei Mac,
    a West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
    b West China School of Basic Medical Science and Forensic Medicine, Sichuan University, Chengdu, Sichuan, PR China
    c Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
    Pancreatic cancer is a lethal cancer with high rate of liver metastasis worldwide, whereas its treatment choices are limited to a large extent. The limitation of current therapeutic strategies calls for an effective approach which can lower the postoperative liver metastasis rate in order to improve the overall prognosis and survival rate. Comprehensively considering the basic knowledge and clinical practice of tumor treatment worldwide, we proposed three points of hypotheses. Basically, the existing evidences indicated that tumor cells shedding from pancreatic cancer localized in the marginal liver preferentially through the Portal vein. Then, the percentage depth dose distribution of electron radiation is consistent with the marginal distribution of liver metastasis from pancreatic cancer. Based on the characteristics of liver metastasis of pancreatic cancer and the percentage depth dose of electron radiation, we provide a new propose of preventing postoperative liver metastasis in a way of prophylactic intraoperative electron radiation therapy on the surface of liver. Intraoperative electron radiation is relatively easy to control radiation dose and treatment area under direct vision, effectively inhibiting the metastasis and growth of cancer cells and preventing further deterioration of pancreatic cancer patients’ condition. Therefore, this hypothesis has an important clinical significance for postoperative rehabilitation and improvement of patients’ survival.
    Introduction
    Pancreatic cancer, though ranking the 13th in the incidence of malignant tumors, remains the 4th leading mortality according to the global statistics on malignant tumors released by WHO in 2014 [1].With incidence risen rapidly worldwide, pancreatic cancer is pro-jected to be the 2nd leading cause of cancer-related deaths to 2030 [2]. As a highly lethal cancer, the overall 5-year survival rate is 8% for all stages included, falling to 3% in patients with advanced pancreatic cancer [3]. Although radical surgical resection is the only prospective treatment of long-term survival for patients with this disease and leads to significantly longer survival compared with other treatment options, the overall 5-year survival rate for postoperative patients remains only 15–20% [4].