Combined multiagent chemotherapy and radiotherapy is associated with prolonged overall survival in patients with non-operatively managed stage II-III pancreatic adenocarcinoma.
Publication/Presentation Date
4-1-2022
Abstract
BACKGROUND: Most patients with pancreatic adenocarcinoma (PDAC) do not undergo surgical resection. The role of radiotherapy (RT) in non-operatively managed localized pancreatic adenocarcinoma is unclear.
METHODS: The National Cancer Database (2010-2016) was queried for patients with clinical stage II-III PDAC treated with multiagent systemic chemotherapy (CT) +/- RT but not surgery. Factors associated with the receipt of RT and overall survival were compared after adjusting for patient demographics and clinical characteristics.
RESULTS: A total of 14,921 patients were included, of whom 9279 received CT and 5382 received CT + RT. Patients treated with CT + RT were more likely to be younger (65vs66yrs), treated at non-academic facilities (48.8%vs46.7%), have private insurance (40.3%vs36.5%), and have clinical T4 tumors (53.6%vs48.7%). Most patients who were treated with RT received external beam radiotherapy (89.3%), and the median dose was 5,000 cGy. Median time to start of RT was 129 days. CT + RT was associated with longer overall survival (15.9vs11.8mos,p < 0.001), and remained associated with survival on multivariable analysis (HR 0.74, 95%CI 0.70-0.78). On a 4-month conditional survival analysis, combined CT + RT remained associated with improved survival compared to CT alone (16.0vs13.1mos,p < 0.001).
CONCLUSIONS: In patients with non-operatively managed localized pancreatic adenocarcinoma, combined radiotherapy and multiagent systemic chemotherapy is associated with improved overall survival compared to chemotherapy alone.
Volume
24
Issue
4
First Page
433
Last Page
442
ISSN
1477-2574
Published In/Presented At
Sugumar, K., Hue, J. J., Hardacre, J. M., Ammori, J. B., Rothermel, L. D., Dorth, J., Saltzman, J., Mohamed, A., Selfridge, J. E., Bajor, D., Winter, J. M., & Ocuin, L. M. (2022). Combined multiagent chemotherapy and radiotherapy is associated with prolonged overall survival in patients with non-operatively managed stage II-III pancreatic adenocarcinoma. HPB : the official journal of the International Hepato Pancreato Biliary Association, 24(4), 433–442. https://doi.org/10.1016/j.hpb.2021.08.938
Disciplines
Medicine and Health Sciences
PubMedID
34465529
Department(s)
Department of Surgery, Lehigh Valley Topper Cancer Institute
Document Type
Article
