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Updated: Aug 10, 2026
Laparoscopic Radical Antegrade Modular Pancreatosplenectomy via Dorsal-Caudal Artery Approach for Pancreatic Neck-Body Cancer
Published on: November 18, 2022
Neoadjuvant Early Stereotactic Body Radiation Therapy Followed by Chemoimmunotherapy in Borderline Resectable and
Shuhan Zhao1,2,3, Jing Tang1,2,3, Xin Li4
1Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Purpose:
Optimal neoadjuvant therapy for borderline resectable pancreatic cancer/locally advanced pancreatic cancer (BRPC/LAPC) remains undefined. This study evaluated the efficacy and safety of neoadjuvant nab-paclitaxel and gemcitabine plus camrelizumab, with or without early stereotactic body radiation therapy (SBRT), among patients with BRPC/LAPC.
Methods And Materials:
This single-center, prospective trial enrolled adults with previously untreated BRPC/LAPC. Patients were assigned to an SBRT cohort, receiving early SBRT (25 Gy in 5 fractions) followed by nab-paclitaxel (125 mg/m2) plus gemcitabine (1000 mg/m2) on days 1 and 8 with camrelizumab (200 mg every 3 weeks), or to a non-SBRT cohort treated with the same chemoimmunotherapy alone. A multidisciplinary team determined whether patients underwent surgery or continued first-line therapy. The objective response rate served as the primary endpoint.
Results:
A total of 22 patients were enrolled (11 in each cohort). The objective response rate was 36.4% (8/22), and disease-control rate was 100% (22/22). Six patients (27.3%) underwent surgery, and all achieved clinical-to-pathologic downstaging and R0 margins (6/6). With a median follow-up of 30.0 months (95% CI, 23.3-36.7), median progression-free survival was 12.5 months (95% CI, 9.6 to not available) in the SBRT cohort and 6.6 months (95% CI, 6.4 to not available) in the non-SBRT cohort in an exploratory between-cohort analysis (P = .003). Median overall survival was 20.8 and 13.9 months in the SBRT and non-SBRT cohorts, respectively (P = .261). Toxicity profiles were similar across cohorts, with grade ≥3 treatment-related adverse events occurring in 36.4% of patients.
Conclusions:
Neoadjuvant nab-paclitaxel and gemcitabine plus camrelizumab, with or without early SBRT, showed encouraging efficacy and acceptable tolerability for BRPC/LAPC. The potential benefit of early SBRT warrants further investigation.
