ORIGINAL ARTICLE Neoadjuvant Chemo-Radiotherapy for Patients with Borderline Resectable Pancreatic Cancer: A Meta-Analytical Evaluation of Prospective Studies

Context For patients with borderline resectable pancreatic cancer, the benefit of neoadjuvant therapy remains to be defined. Objective We did a systematic search of the literature on this topic. Methods Prospective studies where chemotherapy with or without radiotherapy was given before surgery to patients with borderline resectable cancer, were analyzed by a meta-analytical approach. Main outcome measures Primary outcome was surgical exploration and resection rates; tumor response, therapy-induced toxicity, and survival were secondary outcomes. Data were expressed as weighted pooled proportions with 95 % confidence intervals (95 % CI). Results Ten studies with 182 participants were included. Following treatment, 69 % of patients (95 % CI: 56-80%) were brought to surgery and 80 % (95 % CI: 66-90%) of surgically-explored patients were resected. Eighty-three percent (95 % CI: 74-90%) of resected specimens were deemed R0 resections. The weighted fractions of resected patients alive at 1 and 2 years were 61 % (95 % CI: 48-100%) and 44 % (95 % CI: 32-59%), respectively. At restaging following neoadjuvant therapy, weighted frequencies for complete/partial response were 16