Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
Anticancer Res. 2021 Mar;41(3):1629-1639. doi: 10.21873/anticanres.14925.
BACKGROUND/AIM: An association between the pathological response to neoadjuvant chemotherapy (NAC) and the efficacy of adjuvant chemotherapy (AC) in patients with pancreatic ductal adenocarcinoma (PDAC) remains unknown.
A total of 121 patients with PDAC who underwent a pancreatectomy between January 2013 and March 2020 were divided into two groups: an upfront surgery (UFS) group (n=42), and an NAC (gemcitabine plus S-1) group (n=79). In the NAC group, the pathological response was evaluated using the Evans classification.
The overall survival was significantly higher in patients with an AC relative dose intensity (RDI) ≥80% than in patients with an AC RDI <80% in the UFS, NAC-Evans IIa, and NAC-Evans IIb+III groups. However, this difference was not observed in the NAC-Evans I group.
AC is preferable for patients with NAC-Evans IIa or IIb+III, but more effective AC regimens may be needed for NAC-Evans I patients.
背景/目的：新辅助化疗（NAC）的病理反应与胰腺导管腺癌（PDAC）患者辅助化疗（AC）的疗效之间的关系尚不清楚。
2013 年 1 月至 2020 年 3 月间接受胰切除术的 121 例 PDAC 患者分为两组：直接手术（UFS）组（n=42）和 NAC（吉西他滨加 S-1）组（n=79）。在 NAC 组中，采用 Evans 分类法评估病理反应。
在 UFS、NAC-Evans IIa、NAC-Evans IIb+III 组中，AC 相对剂量强度（RDI）≥80%的患者总生存率明显高于 AC RDI<80%的患者。然而，在 NAC-Evans I 组中未观察到这种差异。
对于 NAC-Evans IIa 或 IIb+III 患者，AC 是优选的，但对于 NAC-Evans I 患者，可能需要更有效的 AC 方案。
