局部胰腺癌的单一放射治疗模式。
Radiation as a Single-Modality Treatment in Localized Pancreatic Cancer.
机构信息
From the Department of Hematology and Oncology, Winship Cancer Institute.
Department of Public Health, Emory University, Atlanta, GA.
出版信息
Pancreas. 2020 Jul;49(6):822-829. doi: 10.1097/MPA.0000000000001584.
OBJECTIVES
Locally advanced pancreatic cancer (LAPC) is managed with multimodality therapy. We aim to evaluate the outcome of single-modality radiation therapy for LAPC.
METHODS
Locally advanced pancreatic cancer patients were identified between 2004 and 2013 using the National Cancer Database excluding patients who received chemotherapy or surgery.
RESULTS
A total of 6590 patients were included. The mean age was 73.5 (range, 28-90) years, 83.2% were white, and 54.4% were female. Tumors of 4 cm or greater (>T3 stage) accounted for 52.7%. The median radiation dose was 39.6 Gy. Stereotactic body radiation (SBRT) delivered to 64 patients and external-beam/intensity modulated radiotherapy in 416 patients. Radiation therapy was associated with improved overall survival (OS) compared with no treatment in univariate and multivariable analyses. The medians OS for patients who received SBRT, external-beam/intensity modulated radiotherapy, or no radiation were 8.6, 6.7, and 3.4 months, respectively (P < 0.001). There is a significant difference in 12-month OS for the SBRT cohort (31.9%; 95% confidence interval [CI], 20.9%-43.5%) compared with patients who received no radiation (15.1%; 95% CI, 14.2%-16.0%), and on multivariable analysis (hazard ratio, 0.50; 95% CI, 0.38-0.65; P < 0.001).
CONCLUSIONS
The current study suggests potential benefit for radiation therapy alone in comparison with no treatment in LAPC.
目的
局部晚期胰腺癌（LAPC）采用多模式治疗。我们旨在评估 LAPC 单一模式放射治疗的结果。
方法
使用国家癌症数据库在 2004 年至 2013 年间确定局部晚期胰腺癌患者，排除接受化疗或手术的患者。
结果
共纳入 6590 例患者。平均年龄为 73.5（范围 28-90）岁，83.2%为白人，54.4%为女性。肿瘤直径为 4cm 或以上（> T3 期）占 52.7%。中位放疗剂量为 39.6Gy。64 例患者接受立体定向体部放疗（SBRT），416 例患者接受外照射/调强放疗。与未治疗相比，在单变量和多变量分析中，放疗与总生存期（OS）改善相关。接受 SBRT、外照射/调强放疗或未接受放疗的患者的中位 OS 分别为 8.6、6.7 和 3.4 个月（P <0.001）。SBRT 组 12 个月 OS （31.9%；95%置信区间[CI]，20.9%-43.5%）与未接受放疗的患者（15.1%；95% CI，14.2%-16.0%）相比差异有统计学意义（优势比，0.50；95% CI，0.38-0.65；P <0.001）。
结论
与未治疗相比，当前研究表明 LAPC 单独放疗可能具有潜在益处。
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