非转移性胰腺癌：全身治疗后接受>40Gy 放化疗可改善生存。
Nonmetastatic pancreatic cancer : Improved survival with chemoradiotherapy > 40 Gy after systemic treatment.
机构信息
Department of Radiotherapy and Radio-oncology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
University Clinic of Surgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
出版信息
Strahlenther Onkol. 2018 Jul;194(7):627-637. doi: 10.1007/s00066-018-1281-7. Epub 2018 Mar 1.
PURPOSE
The role of radiotherapy (RT) for nonmetastatic pancreatic cancer is still a matter of debate since randomized control trials have shown inconsistent results. The current retrospective single-institution study includes both resected and unresected patients with nonmetastasized pancreatic cancer. The aim is to analyze overall survival (OS) after irradiation combined with induction chemotherapy.
PATIENTS AND METHODS
Of the 73 patients with nonmetastatic pancreatic cancer eligible for the present analysis, 42 (58%) patients had adjuvant chemoradiotherapy (CRT), while 31 (42%) received CRT as primary treatment. In all, 65 (89%) had chemotherapy at any time before, during, or after RT, and 39 (53%) received concomitant CRT. The median total dose was 50 Gy (range 12-77 Gy), while 61 (84%) patients received >40 Gy.
RESULTS
With a median follow-up of 22 months (range 1.2-179.8 months), 14 (19%) are still alive and 59 (81%) of the patients have died, whereby 51 (70%) were cancer-related deaths. Median OS and the 2‑year survival rate were 22.9 months (1.2-179.8 months) and 44%, respectively. In addition, 61 (84%) patients treated with >40 Gy had a survival advantage (median OS 23.7 vs. 17.3 months, p = 0.026), as had patients with 4 months minimum of systemic treatment (median OS 27.5 vs. 14.3 months, p = 0.0004).
CONCLUSION
CRT with total doses >40 Gy after induction chemotherapy leads to improved OS in patients with nonmetastatic pancreatic cancer.
目的
由于随机对照试验结果不一致，放射治疗（RT）在非转移性胰腺癌中的作用仍存在争议。本回顾性单中心研究包括接受手术和未接受手术的非转移性胰腺癌患者。目的是分析照射联合诱导化疗后的总生存率（OS）。
患者和方法
在符合本分析条件的 73 例非转移性胰腺癌患者中，42 例（58%）患者接受了辅助放化疗（CRT），31 例（42%）患者接受 CRT 作为初始治疗。共有 65 例（89%）患者在 RT 前、期间或之后任何时候接受化疗，39 例（53%）患者接受同步 CRT。中位总剂量为 50 Gy（范围 12-77 Gy），61 例（84%）患者接受>40 Gy。
结果
中位随访时间为 22 个月（范围 1.2-179.8 个月），14 例（19%）仍存活，59 例（81%）患者死亡，其中 51 例（70%）死于癌症相关原因。中位 OS 和 2 年生存率分别为 22.9 个月（1.2-179.8 个月）和 44%。此外，接受>40 Gy 治疗的 61 例患者（中位 OS 23.7 与 17.3 个月，p=0.026）和接受至少 4 个月系统治疗的患者（中位 OS 27.5 与 14.3 个月，p=0.0004）具有生存优势。
结论
在诱导化疗后给予总剂量>40 Gy 的 CRT 可改善非转移性胰腺癌患者的 OS。
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