Department for Abdominal, Thoracic, and Vascular Surgery, Triemli Hospital Zurich, Switzerland.
Department for Radiation Oncology, Triemli Hospital Zurich, Zurich, Switzerland.
Surg Oncol. 2021 Mar;36:36-41. doi: 10.1016/j.suronc.2020.11.012. Epub 2020 Nov 23.
Pancreatic adenocarcinoma (PAC) is a highly malignant tumor with relevant morbidity and mortality. The role of adjuvant chemoradiotherapy (CRT) for primarily resected tumors remains controversial. We aimed to assess the outcome of patients treated at our institution with postoperative CRT for PAC.
We present a retrospective case series of patients with pancreatic adenocarcinoma at a single center in Switzerland. These patients were treated by primary surgery followed by adjuvant CRT between 1995 and 2015. The results were compared with published data.
Median follow-up for the 60 patients was 33 months (range 19.9-193.9); median overall survival (OS) for patients undergoing a resection followed by combined CRT was 25.5 months. Overall, disease-free survival (DFS) was 15.2 months. A local recurrence occurred in 14 patients (23.3%) after a median time of 8.8 months, and in 43 patients (71.7%) distant metastasis was demonstrated with a median time to metastasis of 10.6 months.
This retrospective study represents one of the sole reviews of outcome data after adjuvant CRT in resected PAC in Europe within the past years. OS was comparable to that of other institutional outcome data published previously but inferior when compared to most recent published results with an intense chemotherapy. However, not all patients are suitable to undergo such an intense chemotherapy with modified FOLFIRINOX after the extensive surgery for the PAC - these patients could benefit from adding adjuvant CRT to a less intensive chemotherapy with gemcitabine to enhance the benefit regarding locoregional recurrence-free survival.
胰腺导管腺癌（PAC）是一种高度恶性肿瘤，具有较高的发病率和死亡率。对于主要切除的肿瘤，辅助放化疗（CRT）的作用仍存在争议。我们旨在评估在我们机构接受术后 CRT 治疗的 PAC 患者的结局。
我们展示了瑞士一家单中心的胰腺导管腺癌患者的回顾性病例系列。这些患者接受了原发手术，随后在 1995 年至 2015 年间接受了辅助 CRT 治疗。结果与已发表的数据进行了比较。
60 例患者的中位随访时间为 33 个月（范围 19.9-193.9）；接受切除术加联合 CRT 治疗的患者中位总生存期（OS）为 25.5 个月。总体而言，无疾病生存率（DFS）为 15.2 个月。14 例患者（23.3%）在中位时间 8.8 个月后发生局部复发，43 例患者（71.7%）出现远处转移，转移的中位时间为 10.6 个月。
这项回顾性研究是过去几年中欧洲唯一一项关于切除后 PAC 辅助 CRT 结局数据的综述之一。OS 与之前发表的其他机构的结果数据相当，但与最近发表的使用强化化疗的结果相比则较差。然而，并非所有患者都适合在 PAC 广泛手术后接受如此强烈的化疗加改良 FOLFIRINOX，对于这些患者，在相对温和的吉西他滨化疗基础上添加辅助 CRT 可能会提高局部无复发生存率的获益。
