Division of Hematology-Oncology, Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
Am J Clin Oncol. 2012 Oct;35(5):432-8. doi: 10.1097/COC.0b013e31821a83d7.
To evaluate clinical outcomes and safety of adjuvant chemoradiation therapy (CRT) with capecitabine after resection of pancreatic adenocarcinoma at a single institution.
A retrospective analysis of patients undergoing adjuvant CRT with capecitabine after resection of pancreatic ductal adenocarcinoma between 2004 and 2007 yielded a total of 55 patients. Capecitabine was administered at 850 mg/m(2) twice daily every day per week radiotherapy (45 Gy in 25 fractions) over the 5 weeks. Sixteen percent of patients (N=9) went on to receive gemcitabine.
Of 55 patients, 42 had curative (R0) resection and 13 had incomplete resection (R1). Median overall survival (OS) and progression free survival were 18.3 and 8.0 months for all patients, respectively. Patients receiving additional gemcitabine after adjuvant CRT with capecitabine showed better OS and progression free survival than those not receiving additional gemcitabine (P<0.05). In multivariate analysis, lymphovascular invasion (present vs. absent) and addition gemcitabine therapy (yes vs. no) were significant independent prognostic factors for OS (P<0.05). Local recurrence was observed in 10 patients, and distant recurrence in 26 patients, synchronously accounting for 6 recurrences. Ten patients (18.2%) had severe grade 3 toxicities.
Capecitabine-based CRT after resection of pancreatic adenocarcinoma showed favorable outcomes and tolerable toxicity profiles.
评估单一机构接受卡培他滨辅助放化疗（CRT）治疗后胰腺导管腺癌患者的临床疗效和安全性。
对 2004 年至 2007 年间接受卡培他滨辅助 CRT 治疗的胰腺导管腺癌患者进行回顾性分析，共 55 例患者。卡培他滨的给药方案为每天两次，每次 850mg/m²，每周 5 天，同时给予放疗（25 次 45Gy）。16%（N=9）的患者随后接受了吉西他滨治疗。
55 例患者中，42 例为根治性（R0）切除，13 例为不完全切除（R1）。所有患者的中位总生存期（OS）和无进展生存期（PFS）分别为 18.3 个月和 8.0 个月。接受卡培他滨辅助 CRT 后加用吉西他滨治疗的患者 OS 和 PFS 均优于未加用吉西他滨的患者（P<0.05）。多因素分析显示，脉管侵犯（有 vs. 无）和加用吉西他滨治疗（有 vs. 无）是 OS 的独立预后因素（P<0.05）。10 例患者出现局部复发，26 例患者出现远处转移，6 例患者同时出现局部和远处复发。10 例患者（18.2%）出现 3 级严重毒性。
卡培他滨为基础的 CRT 治疗胰腺导管腺癌具有良好的疗效和可耐受的毒性谱。
