Department of Radiology, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan.
Anticancer Res. 2010 Jul;30(7):2959-67.
To analyze retrospectively the results of postoperative external beam radiotherapy (EBRT) for resected pancreatic adenocarcinoma.
The records of 47 patients treated with gross complete resection (R0: 24 patients, R1: 23 patients) and post-operative EBRT were reviewed. The median dose of EBRT was 50 Gy (range, 12-60 Gy), and chemotherapy was used in 37 patients (78.7%). The median follow-up period for all 47 patients was 14.4 months (range, 0.9-67.9 months).
At the time of this analysis, 24 patients (51.1%) had disease recurrence. Local failure was observed in 10 patients (21.3%), and the 2-year local control (LC) rate in all patients was 68.7%. Patients treated with EBRT and chemotherapy had a significantly more favorable LC (2-year LC rate: 76.0%) than those treated with EBRT alone (2-year LC rate: 40%, p=0.0472). The median survival time and the 2-year actuarial overall survival (OS) in all 47 patients were 30.0 months and 54.5%, respectively. Patients treated with EBRT and chemotherapy had a significantly more favorable OS (2-year OS rate: 61.6%) than those treated with EBRT alone (2-year OS: 25.0%, p=0.0454). On univariate analysis, chemotherapy use alone had a significant impact on OS, and on multivariate analysis, chemotherapy use also was a significant prognostic factor. There were no late morbidities of NCI-CTC Grade 3 or greater.
Post-operative EBRT with chemotherapy yields a favorable LC rate for resected pancreatic adenocarcionoma, and EBRT combined with chemotherapy confers a survival benefit compared to EBRT alone.
回顾性分析接受根治性手术后行术后外照射放疗（EBRT）的胰腺腺癌患者的治疗结果。
回顾性分析了 47 例接受根治性切除（R0：24 例，R1：23 例）和术后 EBRT 治疗的胰腺腺癌患者的病历资料。EBRT 的中位剂量为 50Gy（范围：12-60Gy），37 例（78.7%）患者接受了化疗。所有 47 例患者的中位随访时间为 14.4 个月（范围：0.9-67.9 个月）。
在本次分析时，24 例患者（51.1%）发生疾病复发。10 例患者（21.3%）出现局部失败，所有患者的 2 年局部控制率（LC）为 68.7%。接受 EBRT 联合化疗的患者的 LC 明显更好（2 年 LC 率：76.0%），而单独接受 EBRT 治疗的患者 2 年 LC 率（40%）较低（p=0.0472）。所有 47 例患者的中位生存时间和 2 年总生存率（OS）分别为 30.0 个月和 54.5%。接受 EBRT 联合化疗的患者的 OS 明显优于单独接受 EBRT 治疗的患者（2 年 OS 率：61.6%）（p=0.0454）。单因素分析显示，化疗的使用对 OS 有显著影响，多因素分析显示，化疗的使用也是一个显著的预后因素。无 NCI-CTC 3 级或更高级别的迟发性并发症。
术后 EBRT 联合化疗可提高胰腺腺癌根治性切除术后的局部控制率，与单纯 EBRT 相比，EBRT 联合化疗可带来生存获益。
