The Role of Pancreatic Enzyme Replacement Therapy in Unresectable Pancreatic Cancer: A Prospective Cohort Study
Although patients with pancreatic cancer (PC) are prone to exocrine pancreatic insufficiency, there are little evidence about pancreatic enzyme replacement therapy (PERT) in patients with PC, especially those receiving chemotherapy. This is a prospective consecutive observational study of PERT in pa...
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| Veröffentlicht in: | Pancreas 2017-03, Vol.46 (3), p.341-346 |
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| creator | Saito, Tomotaka Hirano, Kenji Isayama, Hiroyuki Nakai, Yousuke Saito, Kei Umefune, Gyotane Akiyama, Dai Watanabe, Takeo Takagi, Kaoru Hamada, Tsuyoshi Takahara, Naminatsu Uchino, Rie Mizuno, Suguru Kogure, Hirofumi Matsubara, Saburo Yamamoto, Natsuyo Tada, Minoru Koike, Kazuhiko |
| description | Although patients with pancreatic cancer (PC) are prone to exocrine pancreatic insufficiency, there are little evidence about pancreatic enzyme replacement therapy (PERT) in patients with PC, especially those receiving chemotherapy.
This is a prospective consecutive observational study of PERT in patients with unresectable PC. We prospectively enrolled patients receiving chemotherapy for unresectable PC from April 2012 to February 2014 and prescribed oral pancrelipase of 48,000 lipase units per meal (pancrelipase group). N-benzoyl-tryrosyl para-aminobenzoic acid test was performed at baseline. Patients receiving chemotherapy before April 2012 were retrospectively studied as a historical cohort. Data on the nutritional markers at baseline and 16 weeks were extracted, and serial changes, defined as the ratio of markers at 16 weeks/baseline, were compared between 2 groups.
A total of 91 patients (46 in the pancrelipase group and 45 in the historical cohort) were analyzed. N-benzoyl-tryrosyl para-aminobenzoic acid test was low in 94% of the pancrelipase group. Serial change in the pancrelipase group versus historical cohort was 1.01 versus 0.95 in body mass index (P < 0.001) and 1.03 versus 0.97 in serum albumin (P = 0.131).
The rate of exocrine pancreatic insufficiency in unresectable PC was high, and PERT can potentially improve the nutritional status during chemotherapy. |
| doi_str_mv | 10.1097/MPA.0000000000000767 |
| format | Article |
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This is a prospective consecutive observational study of PERT in patients with unresectable PC. We prospectively enrolled patients receiving chemotherapy for unresectable PC from April 2012 to February 2014 and prescribed oral pancrelipase of 48,000 lipase units per meal (pancrelipase group). N-benzoyl-tryrosyl para-aminobenzoic acid test was performed at baseline. Patients receiving chemotherapy before April 2012 were retrospectively studied as a historical cohort. Data on the nutritional markers at baseline and 16 weeks were extracted, and serial changes, defined as the ratio of markers at 16 weeks/baseline, were compared between 2 groups.
A total of 91 patients (46 in the pancrelipase group and 45 in the historical cohort) were analyzed. N-benzoyl-tryrosyl para-aminobenzoic acid test was low in 94% of the pancrelipase group. Serial change in the pancrelipase group versus historical cohort was 1.01 versus 0.95 in body mass index (P < 0.001) and 1.03 versus 0.97 in serum albumin (P = 0.131).
The rate of exocrine pancreatic insufficiency in unresectable PC was high, and PERT can potentially improve the nutritional status during chemotherapy.</description><identifier>ISSN: 0885-3177</identifier><identifier>EISSN: 1536-4828</identifier><identifier>DOI: 10.1097/MPA.0000000000000767</identifier><identifier>PMID: 28099252</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Enzyme Replacement Therapy - methods ; Female ; Gastrointestinal Agents - administration & dosage ; Gastrointestinal Agents - therapeutic use ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Outcome Assessment (Health Care) - methods ; Outcome Assessment (Health Care) - statistics & numerical data ; Pancreas - drug effects ; Pancreas - enzymology ; Pancreas - pathology ; Pancreatic Neoplasms - drug therapy ; Pancrelipase - administration & dosage ; Pancrelipase - therapeutic use ; Proportional Hazards Models ; Prospective Studies</subject><ispartof>Pancreas, 2017-03, Vol.46 (3), p.341-346</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-5362267c5f5c2b68f52129f5e48f87398884705fb9ee9e0e5ef61f81dec59c9a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28099252$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saito, Tomotaka</creatorcontrib><creatorcontrib>Hirano, Kenji</creatorcontrib><creatorcontrib>Isayama, Hiroyuki</creatorcontrib><creatorcontrib>Nakai, Yousuke</creatorcontrib><creatorcontrib>Saito, Kei</creatorcontrib><creatorcontrib>Umefune, Gyotane</creatorcontrib><creatorcontrib>Akiyama, Dai</creatorcontrib><creatorcontrib>Watanabe, Takeo</creatorcontrib><creatorcontrib>Takagi, Kaoru</creatorcontrib><creatorcontrib>Hamada, Tsuyoshi</creatorcontrib><creatorcontrib>Takahara, Naminatsu</creatorcontrib><creatorcontrib>Uchino, Rie</creatorcontrib><creatorcontrib>Mizuno, Suguru</creatorcontrib><creatorcontrib>Kogure, Hirofumi</creatorcontrib><creatorcontrib>Matsubara, Saburo</creatorcontrib><creatorcontrib>Yamamoto, Natsuyo</creatorcontrib><creatorcontrib>Tada, Minoru</creatorcontrib><creatorcontrib>Koike, Kazuhiko</creatorcontrib><title>The Role of Pancreatic Enzyme Replacement Therapy in Unresectable Pancreatic Cancer: A Prospective Cohort Study</title><title>Pancreas</title><addtitle>Pancreas</addtitle><description>Although patients with pancreatic cancer (PC) are prone to exocrine pancreatic insufficiency, there are little evidence about pancreatic enzyme replacement therapy (PERT) in patients with PC, especially those receiving chemotherapy.
This is a prospective consecutive observational study of PERT in patients with unresectable PC. We prospectively enrolled patients receiving chemotherapy for unresectable PC from April 2012 to February 2014 and prescribed oral pancrelipase of 48,000 lipase units per meal (pancrelipase group). N-benzoyl-tryrosyl para-aminobenzoic acid test was performed at baseline. Patients receiving chemotherapy before April 2012 were retrospectively studied as a historical cohort. Data on the nutritional markers at baseline and 16 weeks were extracted, and serial changes, defined as the ratio of markers at 16 weeks/baseline, were compared between 2 groups.
A total of 91 patients (46 in the pancrelipase group and 45 in the historical cohort) were analyzed. N-benzoyl-tryrosyl para-aminobenzoic acid test was low in 94% of the pancrelipase group. Serial change in the pancrelipase group versus historical cohort was 1.01 versus 0.95 in body mass index (P < 0.001) and 1.03 versus 0.97 in serum albumin (P = 0.131).
The rate of exocrine pancreatic insufficiency in unresectable PC was high, and PERT can potentially improve the nutritional status during chemotherapy.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Enzyme Replacement Therapy - methods</subject><subject>Female</subject><subject>Gastrointestinal Agents - administration & dosage</subject><subject>Gastrointestinal Agents - therapeutic use</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Outcome Assessment (Health Care) - methods</subject><subject>Outcome Assessment (Health Care) - statistics & numerical data</subject><subject>Pancreas - drug effects</subject><subject>Pancreas - enzymology</subject><subject>Pancreas - pathology</subject><subject>Pancreatic Neoplasms - drug therapy</subject><subject>Pancrelipase - administration & dosage</subject><subject>Pancrelipase - therapeutic use</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><issn>0885-3177</issn><issn>1536-4828</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkNtKAzEQhoMoth7eQCSX3mxNsptN4l0p9QAVi7bXSzad0JU9mewK69MbaZXi3MzA_N8cfoSuKJlQosTt83I6IYchUnGExpTHaZRIJo_RmEjJo5gKMUJn3r8TQkXM1SkaMUmUYpyNUbPaAn5tSsCNxUtdGwe6Kwye119DFTrQltpABXWHg9LpdsBFjde1Aw-m03kAD6hZKMHd4Sleusa3QVF8Ap4128Z1-K3rN8MFOrG69HC5z-dofT9fzR6jxcvD02y6iAzjaReFJxhLheGWG5an0nJGmbIcEmmliJWUMhGE21wBKCDAwabUSroBw5VROj5HN7u5rWs-evBdVhXeQFnqGpreZ1SmlAuRsCRIk53UhJu9A5u1rqi0GzJKsh-rs2B19t_qgF3vN_R5BZs_6Nfb-BvzcXmu</recordid><startdate>201703</startdate><enddate>201703</enddate><creator>Saito, Tomotaka</creator><creator>Hirano, Kenji</creator><creator>Isayama, Hiroyuki</creator><creator>Nakai, Yousuke</creator><creator>Saito, Kei</creator><creator>Umefune, Gyotane</creator><creator>Akiyama, Dai</creator><creator>Watanabe, Takeo</creator><creator>Takagi, Kaoru</creator><creator>Hamada, Tsuyoshi</creator><creator>Takahara, Naminatsu</creator><creator>Uchino, Rie</creator><creator>Mizuno, Suguru</creator><creator>Kogure, Hirofumi</creator><creator>Matsubara, Saburo</creator><creator>Yamamoto, Natsuyo</creator><creator>Tada, Minoru</creator><creator>Koike, Kazuhiko</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201703</creationdate><title>The Role of Pancreatic Enzyme Replacement Therapy in Unresectable Pancreatic Cancer: A Prospective Cohort Study</title><author>Saito, Tomotaka ; Hirano, Kenji ; Isayama, Hiroyuki ; Nakai, Yousuke ; Saito, Kei ; Umefune, Gyotane ; Akiyama, Dai ; Watanabe, Takeo ; Takagi, Kaoru ; Hamada, Tsuyoshi ; Takahara, Naminatsu ; Uchino, Rie ; Mizuno, Suguru ; Kogure, Hirofumi ; Matsubara, Saburo ; Yamamoto, Natsuyo ; Tada, Minoru ; Koike, Kazuhiko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-5362267c5f5c2b68f52129f5e48f87398884705fb9ee9e0e5ef61f81dec59c9a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Enzyme Replacement Therapy - methods</topic><topic>Female</topic><topic>Gastrointestinal Agents - administration & dosage</topic><topic>Gastrointestinal Agents - therapeutic use</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Outcome Assessment (Health Care) - methods</topic><topic>Outcome Assessment (Health Care) - statistics & numerical data</topic><topic>Pancreas - drug effects</topic><topic>Pancreas - enzymology</topic><topic>Pancreas - pathology</topic><topic>Pancreatic Neoplasms - drug therapy</topic><topic>Pancrelipase - administration & dosage</topic><topic>Pancrelipase - therapeutic use</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saito, Tomotaka</creatorcontrib><creatorcontrib>Hirano, Kenji</creatorcontrib><creatorcontrib>Isayama, Hiroyuki</creatorcontrib><creatorcontrib>Nakai, Yousuke</creatorcontrib><creatorcontrib>Saito, Kei</creatorcontrib><creatorcontrib>Umefune, Gyotane</creatorcontrib><creatorcontrib>Akiyama, Dai</creatorcontrib><creatorcontrib>Watanabe, Takeo</creatorcontrib><creatorcontrib>Takagi, Kaoru</creatorcontrib><creatorcontrib>Hamada, Tsuyoshi</creatorcontrib><creatorcontrib>Takahara, Naminatsu</creatorcontrib><creatorcontrib>Uchino, Rie</creatorcontrib><creatorcontrib>Mizuno, Suguru</creatorcontrib><creatorcontrib>Kogure, Hirofumi</creatorcontrib><creatorcontrib>Matsubara, Saburo</creatorcontrib><creatorcontrib>Yamamoto, Natsuyo</creatorcontrib><creatorcontrib>Tada, Minoru</creatorcontrib><creatorcontrib>Koike, Kazuhiko</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pancreas</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saito, Tomotaka</au><au>Hirano, Kenji</au><au>Isayama, Hiroyuki</au><au>Nakai, Yousuke</au><au>Saito, Kei</au><au>Umefune, Gyotane</au><au>Akiyama, Dai</au><au>Watanabe, Takeo</au><au>Takagi, Kaoru</au><au>Hamada, Tsuyoshi</au><au>Takahara, Naminatsu</au><au>Uchino, Rie</au><au>Mizuno, Suguru</au><au>Kogure, Hirofumi</au><au>Matsubara, Saburo</au><au>Yamamoto, Natsuyo</au><au>Tada, Minoru</au><au>Koike, Kazuhiko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Role of Pancreatic Enzyme Replacement Therapy in Unresectable Pancreatic Cancer: A Prospective Cohort Study</atitle><jtitle>Pancreas</jtitle><addtitle>Pancreas</addtitle><date>2017-03</date><risdate>2017</risdate><volume>46</volume><issue>3</issue><spage>341</spage><epage>346</epage><pages>341-346</pages><issn>0885-3177</issn><eissn>1536-4828</eissn><abstract>Although patients with pancreatic cancer (PC) are prone to exocrine pancreatic insufficiency, there are little evidence about pancreatic enzyme replacement therapy (PERT) in patients with PC, especially those receiving chemotherapy.
This is a prospective consecutive observational study of PERT in patients with unresectable PC. We prospectively enrolled patients receiving chemotherapy for unresectable PC from April 2012 to February 2014 and prescribed oral pancrelipase of 48,000 lipase units per meal (pancrelipase group). N-benzoyl-tryrosyl para-aminobenzoic acid test was performed at baseline. Patients receiving chemotherapy before April 2012 were retrospectively studied as a historical cohort. Data on the nutritional markers at baseline and 16 weeks were extracted, and serial changes, defined as the ratio of markers at 16 weeks/baseline, were compared between 2 groups.
A total of 91 patients (46 in the pancrelipase group and 45 in the historical cohort) were analyzed. N-benzoyl-tryrosyl para-aminobenzoic acid test was low in 94% of the pancrelipase group. Serial change in the pancrelipase group versus historical cohort was 1.01 versus 0.95 in body mass index (P < 0.001) and 1.03 versus 0.97 in serum albumin (P = 0.131).
The rate of exocrine pancreatic insufficiency in unresectable PC was high, and PERT can potentially improve the nutritional status during chemotherapy.</abstract><cop>United States</cop><pmid>28099252</pmid><doi>10.1097/MPA.0000000000000767</doi><tpages>6</tpages></addata></record> |
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| ispartof | Pancreas, 2017-03, Vol.46 (3), p.341-346 |
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| subjects | Adult Aged Aged, 80 and over Enzyme Replacement Therapy - methods Female Gastrointestinal Agents - administration & dosage Gastrointestinal Agents - therapeutic use Humans Kaplan-Meier Estimate Male Middle Aged Multivariate Analysis Outcome Assessment (Health Care) - methods Outcome Assessment (Health Care) - statistics & numerical data Pancreas - drug effects Pancreas - enzymology Pancreas - pathology Pancreatic Neoplasms - drug therapy Pancrelipase - administration & dosage Pancrelipase - therapeutic use Proportional Hazards Models Prospective Studies |
| title | The Role of Pancreatic Enzyme Replacement Therapy in Unresectable Pancreatic Cancer: A Prospective Cohort Study |
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