Department of Oncology, Shanghai Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China.
Pancreatology. 2012 Mar-Apr;12(2):162-9. doi: 10.1016/j.pan.2012.02.002. Epub 2012 Feb 8.
The aim of the article is to perform a focused review of adjuvant chemotherapy with or without radiotherapy for the treatment of resectable pancreatic adenocarcinoma (PAC).
We performed a Medline database search from 1965 to 2010 using the terms "adjuvant," "trial" and "pancreatic cancer".
Adding adjuvant chemotherapy to patients with resectable PAC was associated with significantly increased median overall survival (OS) (odds ratio[OR]: 1.98, p < 0.001), disease-free survival (DFS) (OR: 2.12, p < 0.001), two-year survival (OR: 1.38, p = 0.04) and five-year survival (OR: 2.16, p = 0.007) compared to surgery alone. There was no statistically significant difference observed with regard to OS (OR:0.99, p = 0.93), DFS (OR:0.99, p = 0.95), and two-year survival (OR: 0.90, p = 0.57) between adjuvant chemoradiotherapy and surgery alone. The further analysis showed that single agent gemcitabine was as active as combined chemotherapy or chemoradiation, which was reflected by an OR of 1.13 (p = 0.26) for OS and1.08 (p = 0.47) for DFS.
A significant benefit with regard to DFS and median OS for adjuvant chemotherapy after PAC resection was demonstrated by this analysis. These results do not support the use of adjuvant radiotherapy for PAC.
本文旨在对可切除胰腺腺癌（PAC）的辅助化疗加或不加放疗进行重点综述。
我们使用“辅助”、“试验”和“胰腺癌”等术语，对 1965 年至 2010 年的 Medline 数据库进行了检索。
与单独手术相比，辅助化疗可显著提高可切除 PAC 患者的中位总生存期（OS）（优势比[OR]：1.98，p<0.001）、无病生存期（DFS）（OR：2.12，p<0.001）、两年生存率（OR：1.38，p=0.04）和五年生存率（OR：2.16，p=0.007）。与单独手术相比，OS（OR：0.99，p=0.93）、DFS（OR：0.99，p=0.95）和两年生存率（OR：0.90，p=0.57）方面无统计学差异。进一步分析表明，单药吉西他滨与联合化疗或放化疗同样有效，OS 的 OR 为 1.13（p=0.26），DFS 的 OR 为 1.08（p=0.47）。
本分析表明，PAC 切除术后辅助化疗在 DFS 和中位 OS 方面具有显著获益，这些结果不支持 PAC 辅助放疗的应用。
