Exocrine Pancreatic Insufficiency in Patients with Unresectable Pancreatic Cancer after Symptomatic Surgeries
The aim of study — to investigate the exocrine pancreatic function in patients with unresectable (locally advanced and metastatic) pancreatic cancer after bypass surgery, and evaluate the feasibility, effectiveness and safety of application the replacement high dose enzyme therapy.
Materials and Methods. In the control group of patients (n = 29) in the postoperative period has been administered low-dose enzyme replacement therapy (up to 30,000 U lipase per day), the core group (n = 31) — high-dose enzyme therapy (average 20,000–40,000 U lipase per day). All patients received nutritional support according to the existing protocols, total parenteral nutrition, megestrol acetate or other treatments of pancreatic cachexia are not used. Laboratory measures of nutritional status were serum cholinesterase levels, transferrin, albumin and lymphocyte count. Quality of life was assessed using the EORTC QLQ-C30, exocrine pancreatic function determined by measuring faecal elastase 1 levels. Dynamics of tumor process was evaluated according to the criteria RECIST 1.1. Long-term follow up of patients after surgery (study started 2–3 weeks after surgery) was 16 weeks.
Results and Conclusions. There weren’t deaths due to disease progression or other causes during the study. Side effects associated with the use of enzyme therapy were not observed. It has been proven that high dose enzyme therapy in patients with unresectable pancreatic cancer allows temporarily stop the reduction of body weight, improve the nutritional indices, although not significantly affect the course of disease and quality of life of patients.
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