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Cancer Res Treat. 2016 Jul;48(3):1045-55. doi: 10.4143/crt.2015.226. Epub 2015 Oct 16.

Concurrent Chemoradiotherapy Versus Chemotherapy Alone for Unresectable Locally Advanced Pancreatic Cancer: A Retrospective Cohort Study.

Choi Y1, Oh DY1,2, Kim K3, Chie EK3, Kim TY1,2, Lee KH1,2, Han SW1,2, Im SA1,2, Kim TY1,2, Ha SW3, Bang YJ1,2.

Author information

1
Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
2
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
3
Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea.

Abstract

PURPOSE:

The optimal treatment strategy for locally advanced pancreatic cancer (LAPC), particularly the role of concurrent chemoradiotherapy (CCRT), remains debatable. We compared the clinical outcomes of CCRT and palliative chemotherapy alone (CA) in patients with unresectable LAPC.

MATERIALS AND METHODS:

Patients with LAPC who were consecutively treated between 2003 and 2010 were included. Resectability was evaluated according to National Comprehensive Cancer Network ver. 1.2012. The clinical outcomes for each treatment group (CCRT vs. CA) were evaluated retrospectively.

RESULTS:

Sixty-three patients (58.9%) and 44 patients (41.1%) were treated with CCRT and CA, respectively. The CCRT cohort included patients who were treated with CCRT with or without chemotherapy backbone (CCRT alone, induction chemotherapy-CCRT, CCRT-maintenance chemotherapy, and induction-CCRT-maintenance chemotherapy). Median progression-free survival (PFS) and overall survival (OS) of all patients were 7.2 months and 13.1 months. PFS of the CCRT and CA groups was 9.0 months and 4.4 months, respectively (p=0.020). OS of the CCRT and CA groups was 15.4 months and 9.3 months, respectively (p=0.011). In multivariate analysis, the adjusted hazard ratio of CCRT was 0.536 (p=0.003) for OS and 0.667 (p=0.078) for PFS. Although the pattern of failure was similar in the CCRT and CA groups, the times to both local and distant failure were significantly longer in the CCRT group.

CONCLUSION:

In patients with unresectable LAPC, those who underwent CCRT during their entire treatment courses had longer OS than patients treated with chemotherapy alone.

KEYWORDS:

Chemoradiotherapy; Pancreatic neoplasms; Prognosis

PMID:
26511805
PMCID:
PMC4946358
DOI:
10.4143/crt.2015.226
[Indexed for MEDLINE]
Free PMC Article

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