Tomihara Hideo, Eguchi Hidetoshi, Yamada Daisaku, Gotoh Kunihito, Kawamoto Koichi, Wada Hiroshi, Asaoka Tadafumi, Noda Takehiro, Takeda Yutaka, Tanemura Masahiro, Mori Masaki, Doki Yuichiro
Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Department of Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.
Surg Today. 2017 Feb;47(2):218-226. doi: 10.1007/s00595-016-1405-6. Epub 2016 Sep 1.
Preoperative chemoradiotherapy (CRT) is a novel, emerging treatment strategy for pancreatic ductal adenocarcinoma (PDAC), but it remains unclear whether post-surgery adjuvant chemotherapy is feasible following preoperative CRT. This retrospective study evaluates the feasibility of adjuvant therapy after preoperative CRT.
The subjects of this study were 99 consecutive patients who underwent pancreatectomy for PDAC between January, 2007 and February, 2013 in our hospital. Sixty patients received preoperative CRT: as gemcitabine (GEM) and 40 Gy radiation in 28 (G-CRT group), and as GEM, S-1, and 50.4 Gy radiation in 32 (GS-CRT group). We also evaluated 39 patients who underwent surgery alone (SA group). We investigated adjuvant chemotherapy induction and completion rates and the frequency of adverse events rated ≥grade 3, based on Common Terminology Criteria for Adverse Events (version 4.0) in all three groups.
In the G-CRT, GS-CRT, and SA groups, the induction rates were 78 % (22/28), 78 % (25/32), and 72 % (28/39), respectively; completion rates were 86 % (19/22), 88 % (22/25), and 82 % (23/28), respectively; and adverse event frequencies were 36 % (8/22), 28 % (7/25), and 43 % (12/28), respectively. No significant difference was found among the three groups.
Preoperative CRT was demonstrated to be safe and did not compromise the feasibility of adjuvant chemotherapy.
术前放化疗（CRT）是一种用于胰腺导管腺癌（PDAC）的新型、新兴治疗策略，但术前CRT后术后辅助化疗是否可行仍不清楚。本回顾性研究评估术前CRT后辅助治疗的可行性。
本研究的对象为2007年1月至2013年2月期间在我院连续接受PDAC胰腺切除术的99例患者。60例患者接受术前CRT：28例接受吉西他滨（GEM）和40 Gy放疗（G-CRT组），32例接受GEM、S-1和50.4 Gy放疗（GS-CRT组）。我们还评估了39例单纯接受手术的患者（SA组）。我们根据所有三组的不良事件通用术语标准（第4.0版）调查了辅助化疗的诱导率和完成率以及≥3级不良事件的发生频率。
在G-CRT组、GS-CRT组和SA组中，诱导率分别为78%（22/28）、78%（25/32）和72%（28/39）；完成率分别为86%（19/22）、88%（22/25）和82%（23/28）；不良事件发生频率分别为36%（8/22）、28%（7/25）和43%（12/28）。三组之间未发现显著差异。
术前CRT被证明是安全的，并且不影响辅助化疗的可行性。
