Neoadjuvant Stereotactic Body Radiotherapy After Upfront Chemotherapy Improves Pathologic Outcomes Compared With Chemotherapy Alone for Patients With Borderline Resectable or Locally Advanced Pancreatic Adenocarcinoma Without Increasing Perioperative Toxicity

Autor: Colin S. Hill, Lauren M. Rosati, Chen Hu, Wei Fu, Shuchi Sehgal, Amy Hacker-Prietz, Christopher L. Wolfgang, Matthew J. Weiss, Richard A. Burkhart, Ralph H. Hruban, Ana De Jesus-Acosta, Dung T. Le, Lei Zheng, Daniel A. Laheru, Jin He, Amol K. Narang, Joseph M. Herman
Rok vydání: 2022
Předmět:
Zdroj: Annals of Surgical Oncology. 29:2456-2468
ISSN: 1534-4681
1068-9265
Popis: Background Patients with borderline resectable pancreatic cancer (BRPC) or locally advanced pancreatic cancer (LAPC) are at high risk of margin-positive resection. Neoadjuvant stereotactic body radiation therapy (SBRT) may help sterilize margins, but its additive benefit beyond neoadjuvant chemotherapy (nCT) is unclear. The authors report long-term outcomes for BRPC/LAPC patients explored after treatment with either nCT alone or nCT followed by five-fraction SBRT (nCT-SBRT). Methods Patients with BRPC or LAPC from 2011 to 2016 who underwent resection after nCT alone or nCT-SBRT were retrospectively reviewed. Baseline characteristics were compared, and the propensity score with inverse probability weighting (IPW) was used to compare pathologic/survival outcomes. Results Of 198 patients, 76 received nCT, and 122 received nCT-SBRT. The nCT-SBRT cohort had a higher proportion of LAPC (53% vs 22%; p p = 0.03), but adjuvant chemotherapy was less frequently administered (53% vs 67.1%; p p p p = 0.02). In the multivariate analysis, nCT-SBRT remained associated with R0 resection (p p = 0.81). Conclusions Despite having more advanced disease, the nCT-SBRT cohort was still more likely to undergo an R0 resection and experienced similar survival outcomes compared with the nCT alone cohort.
Databáze: OpenAIRE
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