Long-term survival benefit of upfront chemotherapy in patients with newly diagnosed borderline resectable pancreatic cancer
Autor: | Kevin C. Soares, Daniel A. Laheru, Ana De Jesus-Acosta, Nilofar Azad, Matthew J. Weiss, Lei Zheng, Nita Ahuja, Christopher L. Wolfgang, Yifei Sun, Amol Narang, Valerie Lee, Ross C. Donehower, Dung T. Le, Martin A. Makary, Adrian Murphy, Linda Chen, Avani S. Dholakia, Alex B. Blair, Chiung Yu Huang, Joseph M. Herman, Elliot K. Fishman, Bikram Shrestha, Luis A. Diaz, Tingbo Liang, Victoria M. Kim, Ralph H. Hruban, Lauren M. Rosati, Amy Hacker-Prietz, John L. Cameron, Farzana A. Faisal, Jin He |
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Rok vydání: | 2017 |
Předmět: |
Adult
Male Cancer Research medicine.medical_specialty medicine.medical_treatment pancreatic cancer Kaplan-Meier Estimate 03 medical and health sciences 0302 clinical medicine Borderline resectable Pancreatic cancer Antineoplastic Combined Chemotherapy Protocols Long term survival Biomarkers Tumor Odds Ratio medicine Humans Radiology Nuclear Medicine and imaging In patient neoadjuvant therapy chemoradiation Neoadjuvant therapy Aged Neoplasm Staging Proportional Hazards Models Original Research resectability Aged 80 and over Chemotherapy business.industry Clinical Cancer Research Middle Aged medicine.disease Combined Modality Therapy 3. Good health Surgery Pancreatic Neoplasms Survival Rate Radiation therapy Treatment Outcome Oncology 030220 oncology & carcinogenesis Borderline resectable pancreatic adenocarcinoma Adenocarcinoma Female 030211 gastroenterology & hepatology business Follow-Up Studies |
Zdroj: | Cancer Medicine |
ISSN: | 2045-7634 |
Popis: | The use of neoadjuvant chemotherapy or radiation for borderline resectable pancreatic adenocarcinoma (BL‐PDAC) is increasing. However, the impact of neoadjuvant chemotherapy and radiation therapy on the outcome of BL‐PDAC remains to be elucidated. We performed a retrospective analysis of 93 consecutive patients who were diagnosed with BL‐PDAC and primarily followed at Johns Hopkins Hospital between February 2007 and December 2012. Among 93 patients, 62% received upfront neoadjuvant chemotherapy followed by chemoradiation, whereas 20% received neoadjuvant chemoradiation alone and 15% neoadjuvant chemotherapy alone. Resectability following all neoadjuvant therapy was 44%. Patients who underwent resection with a curative intent had a median overall survival (mOS) of 25.8 months, whereas those who did not undergo surgery had a mOS of 11.9 months. However, resectability and overall survival were not significantly different between the three types of neoadjuvant therapy. Nevertheless, 22% (95% CI, 0.13–0.36) of the 58 patients who received upfront chemotherapy followed by chemoradiation remained alive for a minimum of 48 months compared to none of the 19 patients who received upfront chemoradiation. Among patients who underwent curative surgical resection, 32% (95% CI, 0.19–0.55) of those who received upfront chemotherapy remained disease free at least 48 months following surgical resection, whereas none of the eight patients who received upfront chemoradiation remained disease free beyond 24 months following surgical resection. Neoadjuvant therapy with upfront chemotherapy may result in long‐term survival in a subpopulation of patients with BL‐PDAC. |
Databáze: | OpenAIRE |
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