College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Medical Oncology, Saskatoon Cancer Centre, University of Saskatchewan, Saskatoon, SK, Canada.
PLoS One. 2022 Feb 2;17(2):e0263250. doi: 10.1371/journal.pone.0263250. eCollection 2022.
The current study aimed to determine the association between timing and completion of adjuvant chemotherapy and outcomes in real-world patients with early-stage pancreatic cancer.
In this multi-center cohort study patients with early-stage pancreatic cancer who were diagnosed from 2007-2017 and underwent complete resection in the province of Saskatchewan were examined. Cox proportional multivariate analyses were performed for correlation with recurrence and survival.
Of 168 patients, 71 eligible patients with median age of 69 years and M:F of 37:34 were identified. Median time to the start of adjuvant therapy from surgery was 73 days. Of all patients, 49 (69%) patients completed adjuvant chemotherapy and 22 (31%) required early treatment discontinuation. Median recurrence-free survival of patients who completed treatment was 22 months (95%CI:15.8-28.2) vs. 9 months (3.3-14.7) if treatment was discontinued early (P<0.001). Median overall survival of those who completed treatment was 33 (17.5-48.5) vs. 16 months (17.5-48.5) with early treatment discontinuation (P<0.001). In the multivariate analysis, treatment discontinuation was significantly correlated with recurrent disease, hazard ratio (HR), 2.57 (1.41-4.68), P = 0.002 and inferior survival, HR, 2.55 (1.39-4.68), P = 0.003. No correlation between treatment timing and survival was noted.
Early discontinuation but not the timing of adjuvant chemotherapy correlates with inferior outcomes.
本研究旨在确定辅助化疗的时机和完成情况与真实世界中早期胰腺癌患者结局的关系。
本多中心队列研究纳入了 2007 年至 2017 年期间在萨斯喀彻温省诊断为早期胰腺癌且接受完全切除术的患者。采用 Cox 比例风险回归模型进行多变量分析，以确定与复发和生存的相关性。
在 168 例患者中，有 71 例符合条件的患者入选，中位年龄为 69 岁，男女比例为 37:34。从手术到开始辅助治疗的中位时间为 73 天。所有患者中，49 例（69%）完成了辅助化疗，22 例（31%）需要提前停止治疗。完成治疗的患者无复发生存期的中位数为 22 个月（95%CI：15.8-28.2），而提前停止治疗的患者为 9 个月（3.3-14.7）（P<0.001）。完成治疗的患者总生存期的中位数为 33 个月（17.5-48.5），而提前停止治疗的患者为 16 个月（17.5-48.5）（P<0.001）。多变量分析显示，提前停止治疗与疾病复发显著相关，风险比（HR）为 2.57（1.41-4.68），P=0.002，与生存率降低显著相关，HR 为 2.55（1.39-4.68），P=0.003。辅助化疗的时机与生存无显著相关性。
提前停止辅助化疗而非化疗时机与较差的结局相关。
