4 个疗程和 4 个疗程加 S-1 给药作为胰腺导管腺癌辅助化疗的比较。
Comparison of 4- and 4 plus-courses S-1 administration as adjuvant chemotherapy for pancreatic ductal adenocarcinoma.
机构信息
Department of Hepatobiliary Pancreatic Surgery, Changhai Hospital Affiliated to Navy Medical University (Second Military Medical University), 168 Changhai Road, Shanghai, 200433, China.
Department of General Surgery, Beidaihe Rehabilitation and Recuperation Center of Joint Logistics Support Force, 4 Xihaitan Road, Qinhuangdao, 066100, China.
出版信息
BMC Cancer. 2021 May 26;21(1):612. doi: 10.1186/s12885-021-08380-9.
PURPOSE
The study aimed to investigate the potential benefit of more than 4 courses of S1 adjuvant chemotherapy for patients with pancreatic ductal adenocarcinoma (PDAC) after surgery.
METHOD
Data were retrospectively collected from consecutive patients who underwent S-1 adjuvant chemotherapy following curative pancreatectomy between January 2016 and December 2018. Four-courses and > 4 courses cohorts were compared for overall survival (OS) as a primary outcome, and relapse-free survival (RFS) and adverse event incidence as secondary outcomes.
RESULTS
Four-courses and > 4 courses cohorts comprised 99 patients and 64 ones, respectively. TNM stage (stage II vs. I: HR, 2.125; 95% CI, 1.164-4.213; P = 0.015), duration of S-1 administration (4 vs. > 4 courses: HR, 3.113; 95% CI, 1.531-6.327; P = 0.002) and tumor grade (G3 vs. G1/2: HR, 3.887; 95% CI, 1.922-7.861; P < 0.001) were independent prognostic factors. Under the condition of patients' survival time beyond 8 months, the OS of patients in > 4 courses cohort was significantly prolonged compared with that of 4 courses cohort (4 vs. > 4 courses: HR, 2.284; 95% CI, 1.197-4.358; P = 0.012), especially for patients in TNM stageII (4 vs. > 4 courses: HR, 2.906; 95% CI, 1.275-6.623; P = 0.011).RFS and adverse events incidence did not signifcantly difer between both cohorts.
CONCLUSION
Prolonged duration of S-1 intake is beneficial to prognosis of patients with PDAC resection.
目的
本研究旨在探讨对于术后接受胰腺导管腺癌（PDAC）S1 辅助化疗的患者，接受超过 4 个疗程化疗的潜在获益。
方法
回顾性收集了 2016 年 1 月至 2018 年 12 月期间接受 S1 辅助化疗的根治性胰腺切除术患者的数据。将 4 个疗程组和>4 个疗程组的总生存期（OS）作为主要终点进行比较，并将无复发生存期（RFS）和不良事件发生率作为次要终点。
结果
4 个疗程组和>4 个疗程组分别包括 99 例和 64 例患者。TNM 分期（Ⅱ期比Ⅰ期：HR，2.125；95%CI，1.164-4.213；P=0.015）、S1 给药持续时间（4 个疗程比>4 个疗程：HR，3.113；95%CI，1.531-6.327；P=0.002）和肿瘤分级（G3 比 G1/2：HR，3.887；95%CI，1.922-7.861；P<0.001）是独立的预后因素。在患者生存时间超过 8 个月的情况下，>4 个疗程组的 OS 明显长于 4 个疗程组（4 个疗程比>4 个疗程：HR，2.284；95%CI，1.197-4.358；P=0.012），特别是在 TNM 分期Ⅱ期的患者中（4 个疗程比>4 个疗程：HR，2.906；95%CI，1.275-6.623；P=0.011）。两组的 RFS 和不良事件发生率无显著差异。
结论
延长 S1 摄入时间有利于 PDAC 切除患者的预后。
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