Department of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan.
Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan;
Anticancer Res. 2023 Feb;43(2):809-815. doi: 10.21873/anticanres.16222.
BACKGROUND/AIM: The standard treatment for resectable pancreatic cancer is preoperative adjuvant chemotherapy (NAC) + curative surgery + adjuvant chemotherapy. Although excellent local control results of carbon ion radiotherapy (CIRT) for pancreatic cancer have been reported, no reports have compared CIRT with the standard treatment for resectable pancreatic cancer. In this study, we compared the results of CIRT for resectable pancreatic cancer with those of standard therapy and investigated the usefulness of CIRT.
The subjects were 35 patients who underwent CIRT for clinical cT1-2, N0-1, and M0 cancers at Kanagawa Cancer Center, Yokohama, Japan, from September 2018 to September 2021, and 110 patients who underwent standard treatment (NAC + curative surgery + adjuvant). Overall survival (OS) and recurrence-free survival (PFS) were compared between the two groups using propensity score-matching (PSM).
Twenty-three CIRT monotherapy patients were matched with NAC + curative surgery + adjuvant chemotherapy patients by PSM. Although there was no significant difference in RFS between the two groups, OS was significantly poorer in the CIRT monotherapy group than in the NAC + curative surgery + adjuvant chemotherapy group.
This single-centre retrospective propensity score-matched comparison of CIRT and NAC + curative resection + adjuvant chemotherapy as the standard therapy for resectable pancreatic cancer showed an inferiority of CIRT in terms of OS, but no difference in PFS. Therefore, CIRT monotherapy may be a treatment strategy for patients with contraindications for standard treatment of curative surgery plus perioperative chemotherapy.
背景/目的：可切除胰腺癌的标准治疗方法是术前辅助化疗（NAC）+根治性手术+辅助化疗。虽然已经报道了碳离子放疗（CIRT）治疗胰腺癌具有出色的局部控制效果，但尚无报道将 CIRT 与可切除胰腺癌的标准治疗方法进行比较。在本研究中，我们比较了 CIRT 治疗可切除胰腺癌的结果与标准治疗的结果，并探讨了 CIRT 的有用性。
本研究的对象为 2018 年 9 月至 2021 年 9 月在日本神奈川癌症中心接受 CIRT 治疗的临床 cT1-2、N0-1 和 M0 期癌症的 35 例患者，以及接受标准治疗（NAC+根治性手术+辅助）的 110 例患者。使用倾向评分匹配（PSM）比较两组患者的总生存（OS）和无复发生存（PFS）。
通过 PSM 将 23 例 CIRT 单药治疗患者与 NAC+根治性手术+辅助化疗患者进行匹配。尽管两组患者的 RFS 无显著差异，但 CIRT 单药治疗组的 OS 明显差于 NAC+根治性手术+辅助化疗组。
本研究为单中心回顾性倾向评分匹配比较，结果显示，与 NAC+根治性切除+辅助化疗作为可切除胰腺癌的标准治疗方法相比，CIRT 的 OS 较差，但 PFS 无差异。因此，CIRT 单药治疗可能是适合标准治疗（根治性手术加围手术期化疗）禁忌的患者的一种治疗策略。
