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Dynamic changes in tumor blood flow during chemotherapy: Implications in customized treatment for pancreatic cancer

  • Authors:
    • Hiromitsu Maehira
    • Takeru Maekawa
    • Yoshihisa Tsuji
    • Haruki Mori
    • Nobuhito Nitta
    • Takeshi Sonoda
    • Reiko Otake
    • Soichiro Tani
    • Katsushi Takebayashi
    • Masatsugu Kojima
    • Sachiko Kaida
    • Toru Miyake
    • Masaji Tani
  • View Affiliations / Copyright

    Affiliations: Department of Surgery, Shiga University of Medical Science, Otsu, Shiga 520‑2192, Japan, Department of Community and General Medicine, Sapporo Medical University, Sapporo, Hokkaido 060‑8556, Japan
    Copyright: © Maehira et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 579
    |
    Published online on: October 8, 2025
       https://doi.org/10.3892/ol.2025.15325
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Abstract

Pancreatic ductal adenocarcinoma (PDAC) is the most lethal malignancy, and the optimal selection of neoadjuvant chemotherapy (NAC) remains a critical clinical challenge. Tumor blood flow (TBF) is associated with chemotherapeutic response. However, the role of TBF in regimen‑specific outcomes remains unclear. Thus, this association was investigated in the present study. A total of 58 patients with PDAC who underwent pancreatectomy after NAC between 2011 and 2023 were retrospectively analyzed. TBF was quantified using contrast‑enhanced computed tomography. Patients were stratified into high and low pre‑treatment TBF groups, and the associations between TBF, chemotherapy regimen [gemcitabine plus S‑1 (GS), gemcitabine plus nab‑paclitaxel (GnP) and modified FOLFIRINOX (mFOLFIRINOX)] and therapeutic pathological response were evaluated. Changes in TBF after treatment and intra‑tumoral vascular characteristics were also assessed. A total of 35 (60.3%) and 23 (39.7%) patients were categorized into the low and high TBF groups, respectively. The prevalence of a therapeutic pathological response of at least grade II was greater in the high TBF group (P=0.027). A higher pre‑treatment TBF was associated with an improved therapeutic pathological response in patients receiving mFOLFIRINOX (P=0.010) but not in those receiving GnP or GS. In patients with low pre‑treatment TBF, GnP therapy increased TBF post‑treatment (P=0.004), whereas mFOLFIRINOX and GS did not. Furthermore, post‑treatment TBF was correlated with the number of intra‑tumoral patent vessels (r=0.486; P<0.001). In conclusion, TBF may serve as a predictive biomarker for selecting neoadjuvant chemotherapy regimens for PDAC. High pre‑treatment TBF was associated with improved efficacy of mFOLFIRINOX, whereas GnP may be beneficial for tumors with initially low TBF by improving tumor perfusion during therapy.
View Figures

Figure 1

Figure 2

Association between TBF and
therapeutic pathological response in each regimen. The red line
indicates the cutoff borderline of high and low TBF groups. (A)
Gemcitabine + S-1. (B) Gemcitabine + nab-paclitaxel. (C) Modified
FOLFIRINOX. N.S., not significant; TBF, tumor blood flow.

Figure 3

Frequency of each therapeutic
pathological response grade by regimen in the low and high TBF
groups. (A) Low TBF group. (B) High TBF group. TBF, tumor blood
flow.

Figure 4

Changes in TBF before and after
treatment for each regimen. (A) All patients. (B) Patients with low
TBF. The horizontal lines in the boxes indicate median values. The
circle dots indicate mean values. *P<0.05, **P<0.01 (Wilcoxon
signed rank test). N.S., not significant; TBF, tumor blood
flow.

Figure 5

Assessment of intra-tumoral vessels.
(A) Representative images of immunohistochemistry for CD31 in human
pancreatic ductal adenocarcinoma in the low post-treatment TBF
group. Orange arrowheads denote vessels that have a clearly visible
lumen (patent vessels). White arrows denote closed vessels. Scale
bar, 100 µm. (B) Representative images of immunohistochemistry for
CD31 in human pancreatic ductal adenocarcinoma in the high
post-treatment TBF group. Orange arrowheads denote vessels that
have a clearly visible lumen (patent vessels). White arrows denote
closed vessels. Scale bar, 100 µm. (C) Comparison of the area of
intra-tumoral vessels in the high and low post-treatment TBF
groups. (D) Comparison of the number of intra-tumoral patent
vessels in the high and low post-treatment TBF groups. (E) Scatter
diagram showing the relationship between the post-treatment TBF and
the area of intra-tumoral vessels. These two factors were not
correlated, with a Spearman's rank correlation coefficient of 0.044
(P=0.754). (F) Scatter diagram showing the relationship between the
post-treatment TBF and the number of intra-tumoral patent vessels.
These two factors are positively correlated, with a Spearman's rank
correlation coefficient of 0.486 (P<0.001). **P<0.01
(Mann-Whitney U test). N.S., not significant; TBF, tumor blood
flow.
View References

1 

Siegel RL, Kratzer TB, Giaquinto AN, Sung H and Jemal A: Cancer statistics, 2025. CA Cancer J Clin. 75:10–45. 2025.PubMed/NCBI

2 

Maehira H, Miyake T, Iida H, Tokuda A, Mori H, Yasukawa D, Mukaisho KI, Shimizu T and Tani M: Vimentin expression in tumor microenvironment predicts survival in pancreatic ductal adenocarcinoma: heterogeneity in fibroblast population. Ann Surg Oncol. 26:4791–4804. 2019. View Article : Google Scholar : PubMed/NCBI

3 

Andriulli A, Festa V, Botteri E, Valvano MR, Koch M, Bassi C, Maisonneuve P and Sebastiano PD: Neoadjuvant/preoperative gemcitabine for patients with localized pancreatic cancer: A meta-analysis of prospective studies. Ann Surg Oncol. 19:1644–1662. 2012. View Article : Google Scholar : PubMed/NCBI

4 

Kato H, Usui M, Isaji S, Nagakawa T, Wada K, Unno M, Nakao A, Miyakawa S and Ohta T: Clinical features and treatment outcome of borderline resectable pancreatic head/body cancer: A multi-institutional survey by the Japanese society of pancreatic surgery. J Hepatobiliary Pancreat Sci. 20:601–610. 2013. View Article : Google Scholar : PubMed/NCBI

5 

D'Angelo F, Antolino L, Farcomeni A, Sirimarco D, Kazemi Nava A, De Siena M, Petrucciani N, Nigri G, Valabrega S, Aurello P and Ramacciato G: Neoadjuvant treatment in pancreatic cancer: Evidence-based medicine? A systematic review and meta-analysis. Med Oncol. 34:852017. View Article : Google Scholar : PubMed/NCBI

6 

Satoi S, Yamaue H, Kato K, Takahashi S, Hirono S, Takeda S, Eguchi H, Sho M, Wada K, Shinchi H, et al: Role of adjuvant surgery for patients with initially unresectable pancreatic cancer with a long-term favorable response to non-surgical anti-cancer treatments: Results of a project study for pancreatic surgery by the Japanese society of hepato-biliary-pancreatic surgery. J Hepatobiliary Pancreat Sci. 20:590–600. 2013. View Article : Google Scholar : PubMed/NCBI

7 

Motoi F, Satoi S, Honda G, Wada K, Shinchi H, Matsumoto I, Sho M, Tsuchida A and Unno M; Study Group of Preoperative therapy for Pancreatic cancer (PREP), : A single-arm, phase II trial of neoadjuvant gemcitabine and S1 in patients with resectable and borderline resectable pancreatic adenocarcinoma: PREP-01 study. J Gastroenterol. 54:194–203. 2019. View Article : Google Scholar : PubMed/NCBI

8 

Unno M, Motoi F, Matsuyama Y, Satoi S, Toyama H, Matsumoto I, Aosasa S, Shirakawa H, Wada K, Fujii T, et al: Neoadjuvant chemotherapy with gemcitabine and S-1 versus upfront surgery for resectable pancreatic cancer: Results of the randomized phase II/III Prep-02/JSAP05 trial. Ann Surg. April 16–2025.(Epub ahead of print). View Article : Google Scholar

9 

Li D, Xie K, Wolff R and Abbruzzese JL: Pancreatic cancer. Lancet. 363:1049–1057. 2004. View Article : Google Scholar : PubMed/NCBI

10 

Maehira H, Tsuji Y, Iida H, Mori H, Nitta N, Maekawa T, Kaida S, Miyake T and Tani M: Estimated tumor blood flow as a predictive imaging indicator of therapeutic response in pancreatic ductal adenocarcinoma: Use of three-phase contrast-enhanced computed tomography. Int J Clin Oncol. 27:373–382. 2022. View Article : Google Scholar : PubMed/NCBI

11 

Neesse A, Michl P, Frese KK, Feig C, Cook N, Jacobetz MA, Lolkema MP, Buchholz M, Olive KP, Gress TM and Tuveson DA: Stromal biology and therapy in pancreatic cancer. Gut. 60:861–868. 2011. View Article : Google Scholar : PubMed/NCBI

12 

Neesse A, Bauer CA, Öhlund D, Lauth M, Buchholz M, Michl P, Tuveson DA and Gress TM: Stromal biology and therapy in pancreatic cancer: Ready for clinical translation? Gut. 68:159–171. 2019. View Article : Google Scholar : PubMed/NCBI

13 

Wolff RA, Wang-Gillam A, Alvarez H, Tiriac H, Engle D, Hou S, Groff AF, San Lucas A, Bernard V, Allenson K, et al: Dynamic changes during the treatment of pancreatic cancer. Oncotarget. 9:14764–14790. 2018. View Article : Google Scholar : PubMed/NCBI

14 

Hamdy A, Ichikawa Y, Toyomasu Y, Nagata M, Nagasawa N, Nomoto Y, Sami H and Sakuma H: Perfusion CT to assess response to neoadjuvant chemotherapy and radiation therapy in pancreatic ductal adenocarcinoma: Initial experience. Radiology. 292:628–635. 2019. View Article : Google Scholar : PubMed/NCBI

15 

Miles KA: Measurement of tissue perfusion by dynamic computed tomography. Br J Radiol. 64:409–412. 1991. View Article : Google Scholar : PubMed/NCBI

16 

Ishida M, Fujii T, Kishiwada M, Shibuya K, Satoi S, Ueno M, Nakata K, Takano S, Uchida K, Ohike N, et al: Japanese classification of pancreatic carcinoma by the Japan pancreas society: Eight edition. J Hepatobiliary Pancreat Sci. 31:755–768. 2024. View Article : Google Scholar : PubMed/NCBI

17 

Kanda Y: Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 48:452–458. 2013. View Article : Google Scholar : PubMed/NCBI

18 

Koyasu S, Tsuji Y, Harada H, Nakamoto Y, Nobashi T, Kimura H, Sano K, Koizumi K, Hamaji M and Togashi K: Evaluation of tumor associated stroma and its relationship with tumor hypoxia using dynamic contrast-enhanced CT and (18)F misonidazole PET in murine tumor models. Radiology. 278:734–741. 2016. View Article : Google Scholar : PubMed/NCBI

19 

Alvarez R, Musteanu M, Garcia-Garcia E, Lopez-Casas PP, Megias D, Guerra C, Muñoz M, Quijano Y, Cubillo A, Rodriguez-Pascual J, et al: Stromal disrupting effects of nab-paclitaxel in pancreatic cancer. Br J Cancer. 109:926–933. 2013. View Article : Google Scholar : PubMed/NCBI

20 

Wang C, Xi W, Jiang J, Ji J, Yu Y, Zhu Z and Zhang J: Metronomic chemotherapy remodel cancer-associated fibroblasts to decrease chemoresistance of gastric cancer in nude mice. Oncol Lett. 14:7903–7909. 2017.PubMed/NCBI

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Copy and paste a formatted citation
Spandidos Publications style
Maehira H, Maekawa T, Tsuji Y, Mori H, Nitta N, Sonoda T, Otake R, Tani S, Takebayashi K, Kojima M, Kojima M, et al: Dynamic changes in tumor blood flow during chemotherapy: Implications in customized treatment for pancreatic cancer. Oncol Lett 30: 579, 2025.
APA
Maehira, H., Maekawa, T., Tsuji, Y., Mori, H., Nitta, N., Sonoda, T. ... Tani, M. (2025). Dynamic changes in tumor blood flow during chemotherapy: Implications in customized treatment for pancreatic cancer. Oncology Letters, 30, 579. https://doi.org/10.3892/ol.2025.15325
MLA
Maehira, H., Maekawa, T., Tsuji, Y., Mori, H., Nitta, N., Sonoda, T., Otake, R., Tani, S., Takebayashi, K., Kojima, M., Kaida, S., Miyake, T., Tani, M."Dynamic changes in tumor blood flow during chemotherapy: Implications in customized treatment for pancreatic cancer". Oncology Letters 30.6 (2025): 579.
Chicago
Maehira, H., Maekawa, T., Tsuji, Y., Mori, H., Nitta, N., Sonoda, T., Otake, R., Tani, S., Takebayashi, K., Kojima, M., Kaida, S., Miyake, T., Tani, M."Dynamic changes in tumor blood flow during chemotherapy: Implications in customized treatment for pancreatic cancer". Oncology Letters 30, no. 6 (2025): 579. https://doi.org/10.3892/ol.2025.15325
Copy and paste a formatted citation
x
Spandidos Publications style
Maehira H, Maekawa T, Tsuji Y, Mori H, Nitta N, Sonoda T, Otake R, Tani S, Takebayashi K, Kojima M, Kojima M, et al: Dynamic changes in tumor blood flow during chemotherapy: Implications in customized treatment for pancreatic cancer. Oncol Lett 30: 579, 2025.
APA
Maehira, H., Maekawa, T., Tsuji, Y., Mori, H., Nitta, N., Sonoda, T. ... Tani, M. (2025). Dynamic changes in tumor blood flow during chemotherapy: Implications in customized treatment for pancreatic cancer. Oncology Letters, 30, 579. https://doi.org/10.3892/ol.2025.15325
MLA
Maehira, H., Maekawa, T., Tsuji, Y., Mori, H., Nitta, N., Sonoda, T., Otake, R., Tani, S., Takebayashi, K., Kojima, M., Kaida, S., Miyake, T., Tani, M."Dynamic changes in tumor blood flow during chemotherapy: Implications in customized treatment for pancreatic cancer". Oncology Letters 30.6 (2025): 579.
Chicago
Maehira, H., Maekawa, T., Tsuji, Y., Mori, H., Nitta, N., Sonoda, T., Otake, R., Tani, S., Takebayashi, K., Kojima, M., Kaida, S., Miyake, T., Tani, M."Dynamic changes in tumor blood flow during chemotherapy: Implications in customized treatment for pancreatic cancer". Oncology Letters 30, no. 6 (2025): 579. https://doi.org/10.3892/ol.2025.15325
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