Additional adjuvant radiotherapy improves survival at 1 year after surgical treatment for pancreatic cancer patients with T4, N2 disease, positive resection margin, and receiving adjuvant chemotherapy

Frontiers in Oncology

Oncology

Yuxiu Ouyang¹  Minzhi Lv²  Xi Guo³  Yuhong Zhou³  Dansong Wang⁴  Wenchuan Wu⁵  Wenhui Lou⁵  Yaolin Xu⁵  Zhaochong Zeng⁶  Lili Wu⁶  Shisuo Du⁶  Yue Fan⁷ 

[1] Department of Abdominal Tumor Radiotherapy, Guangdong Province Zhongshan City People's Hospital, Zhongshan, Guangdong, China;Department of Biostatistics, Zhongshan Hospital Fudan University, Shanghai, China;Department of Medical Oncology, Zhongshan Hospital Fudan University, Shanghai, China;Department of Pancreatic Surgery, Zhongshan Hospital Fudan University, Shanghai, China;Department of Pancreatic Surgery, Zhongshan Hospital Fudan University, Shanghai, China;Cancer Center, Zhongshan Hospital Fudan University, Shanghai, China;Department of General Surgery, Zhongshan Hospital Fudan University, Shanghai, China;Department of Radiotherapy, Zhongshan Hospital Fudan University, Shanghai, China;Department of Traditional Chinese Medicine, Zhongshan Hospital Fudan University, Shanghai, China;

关键词: pancreatic ductal adenocarcinoma;    radiotherapy;    chemotherapy;    surgery;    overall survival;   

DOI  :  10.3389/fonc.2023.1109068

 received in 2022-11-27, accepted in 2023-06-27,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundWhile adjuvant chemotherapy has been established as standard practice following radical resection of pancreatic ductal adenocarcinoma (PDAC), the role of adjuvant radiation therapy (RT) and which patients may benefit remains unclear.MethodsThis retrospective study included PDAC patients who received pancreatic surgery from April 2012 to December 2019 in Zhongshan Hospital Fudan University. Patients with carcinoma in situ, distant metastasis, and without adjuvant chemotherapy were excluded. Cox proportional hazards modeling of survival were constructed to find potential prognostic factors. Propensity score matching (PSM) and exploratory subgroup analyses were used to create a balanced covariate distribution between groups and to investigate therapeutic effect of radiotherapy in certain subgroups.ResultsA total of 399 patients were finally included, 93 of them receiving adjuvant chemoradiotherapy (C+R+) and 306 of them receiving chemotherapy only. Patients in C+R+ group were more likely to be male patients with T3-4 disease. Lymph node metastases was the only negative prognostic factor associated with overall survival (OS). Additional adjuvant RT was not associated with an OS benefit both before and after PSM. Surprisingly, a trend towards improved OS with RT among patients with either T4, N2 disease or R1 resection becomes significant in patients alive more than 1 year after surgery.ConclusionAdjuvant RT was not associated with an OS benefit across all patients, though did show a possible OS benefit for the subgroup with T4N2 disease or R1 resection at 1 year after surgery.

【 授权许可】

Unknown   
Copyright © 2023 Wu, Xu, Zhou, Zeng, Fan, Wang, Wu, Guo, Lv, Ouyang, Du and Lou