1 Yonsei University College of Medicine, Yonsei Cancer Center, Severance Hospital, Seoul, Korea.
Integr Cancer Ther. 2019 Jan-Dec;18:1534735418816825. doi: 10.1177/1534735418816825. Epub 2018 Dec 3.
Surgical resection followed by adjuvant chemotherapy is the only therapeutic option in pancreatic cancer. However, there is limited research evaluating methods of improving adherence to adjuvant treatment after curative resection.
From January 1995 to December 2014, 323 patients with pancreatic cancer who underwent pancreatectomy at the Severance Hospital were enrolled in this study. We retrospectively analyzed clinicopathologic factors with propensity score matching method.
The final study population was 217, after excluding patients undergoing neoadjuvant treatment or palliative resection, those who died within 30 days after operation, and those lost to follow-up after discharge. Among them, 161 received adjuvant treatment after curative resection. Cox's proportional hazard models revealed that nodal metastasis, perioperative transfusion, and completion of adjuvant treatment were significantly correlated with cancer recurrence and cancer-related death ( P < .05). Phellinus linteus (PL) medication was the only significant predictor for completion of adjuvant treatment after curative resection in logistic regression analysis ( P = .039). Disease-free and overall survival of the PL medication group were significantly higher than the no PL medication group ( P < .05).
PL medication potentially contributed to long-term oncologic outcomes by increasing patients' adherence to postoperative adjuvant chemotherapy, which resulted from PL medication associated with low toxicity of chemotherapy.
手术切除加辅助化疗是胰腺癌唯一的治疗选择。然而,目前关于改善根治性切除术后辅助治疗依从性的方法研究有限。
本研究纳入了 1995 年 1 月至 2014 年 12 月在 Severance 医院接受胰切除术的 323 例胰腺癌患者。我们采用倾向评分匹配法对临床病理因素进行了回顾性分析。
最终研究人群为 217 例,排除了接受新辅助治疗或姑息性切除术、术后 30 天内死亡以及出院后失访的患者。其中 161 例患者在根治性切除术后接受了辅助治疗。Cox 比例风险模型显示,淋巴结转移、围手术期输血和辅助治疗完成情况与癌症复发和癌症相关死亡显著相关(P<0.05)。在逻辑回归分析中,服用香菇多糖(PL)药物是根治性切除术后完成辅助治疗的唯一显著预测因素(P=0.039)。PL 药物组的无病生存期和总生存期明显高于无 PL 药物组(P<0.05)。
PL 药物可能通过增加患者对术后辅助化疗的依从性来提高长期肿瘤学结局,这归因于 PL 药物与化疗的低毒性相关。