辅助放疗对切除的胰尾腺癌具有生存获益。

Adjuvant radiation provides survival benefit for resected pancreatic adenocarcinomas of the tail.

作者信息

Jin William H, Hoffe Sarah E, Shridhar Ravi, Strom Tobin, Venkat Puja, Springett Gregory M, Hodul Pamela J, Pimiento Jose M, Meredith Kenneth L, Malafa Mokenge P, Frakes Jessica M

机构信息

University of South Florida Morsani College of Medicine, Tampa, FL, USA.

Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA.

出版信息

J Gastrointest Oncol. 2018 Jun;9(3):487-494. doi: 10.21037/jgo.2018.02.02.

DOI:10.21037/jgo.2018.02.02

PMID:29998014

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6006031/

Abstract

BACKGROUND

The appropriate adjuvant treatment for resected pancreatic cancer remains a controversy. We sought to determine the effect of adjuvant treatment on overall survival (OS) in patients with pancreatic tail adenocarcinoma.

METHODS

Retrospective review of patients with upfront surgically resected pancreatic tail cancer treated at our institution between 2000-2012 was performed to determine outcomes of patients treated with and without adjuvant radiation therapy (RT). Survival curves were calculated according to the Kaplan-Meier method. Univariate analysis (UVA) and multivariate analysis (MVA) were performed using the Cox proportional hazards model.

RESULTS

Thirty-four patients met inclusion criteria. 79% received adjuvant chemotherapy, either concurrent with RT or alone. The groups were well matched, with the only significant difference being patient sex. On both UVA and MVA there was significantly worse survival in patients with a post-op CA19-9 >90 [hazard ratio (HR) 5.55; 95% confidence interval (CI): 1.20-25.7, P=0.03] and improved survival in patients treated with adjuvant RT (HR 0.15; 95% CI: 0.04-0.58, P=0.006). The median and 2-year OS were 21.6 months and 47% for patients treated with adjuvant RT compared with 11.3 months and 21% for those treated without RT.

CONCLUSIONS

Although few in patient numbers, this data suggests integration of adjuvant RT in resected pancreatic tail adenocarcinoma may improve OS.

摘要

背景

对于切除术后的胰腺癌，合适的辅助治疗仍存在争议。我们试图确定辅助治疗对胰尾腺癌患者总生存期（OS）的影响。

方法

对2000年至2012年在我院接受 upfront 手术切除的胰尾癌患者进行回顾性研究，以确定接受和未接受辅助放疗（RT）患者的结局。根据Kaplan-Meier方法计算生存曲线。使用Cox比例风险模型进行单因素分析（UVA）和多因素分析（MVA）。

结果

34例患者符合纳入标准。79%的患者接受了辅助化疗，或与放疗同时进行，或单独进行。两组匹配良好，唯一显著的差异是患者性别。在UVA和MVA中，术后CA19-9>90的患者生存率显著较差[风险比（HR）5.55；95%置信区间（CI）：1.20-25.7，P=0.03]，而接受辅助放疗的患者生存率有所提高（HR 0.15；95%CI：0.04-0.58，P=0.006）。接受辅助放疗的患者的中位OS和2年OS分别为21.6个月和47%，而未接受放疗的患者分别为11.3个月和21%。