Margin negative resection and pathologic downstaging with multiagent chemotherapy with or without radiotherapy in patients with localized pancreas cancer: A national cancer database analysis
| Autor: | Kimberly L. Johung, Joseph M. Herman, Michael Cecchini, Stacey Stein, Joseph A. Miccio, Jill Lacy, Jeremy S. Kortmansky, Christopher L. Hallemeier, Salma K. Jabbour, Sajid A. Khan, Krishan R. Jethwa, Ronald R. Salem, Henry S. Park, Amol Narang, Timil Patel, Wesley J. Talcott |
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| Rok vydání: | 2021 |
| Předmět: |
Oncology
medicine.medical_specialty UVA univariable analysis Lymphovascular invasion PDAC pancreatic ductal adenocarcinoma medicine.medical_treatment R895-920 LR logistic regression RT radiotherapy Article 030218 nuclear medicine & medical imaging OS overall survival Medical physics. Medical radiology. Nuclear medicine 03 medical and health sciences 0302 clinical medicine Pancreatic cancer Internal medicine medicine Chemotherapy Radiology Nuclear Medicine and imaging MAC multiagent chemotherapy RC254-282 IQR interquartile range Neoadjuvant therapy Radiotherapy business.industry Proportional hazards model Neoplasms. Tumors. Oncology. Including cancer and carcinogens NCDB National Cancer Database Cancer pCR pathologic complete response MVA multivariable analysis medicine.disease LVI lymphovascular invasion Radiation therapy Regimen 030220 oncology & carcinogenesis AJCC American Joint Committee on Cancer R0 margin negative Surgery business |
| Zdroj: | Clinical and Translational Radiation Oncology Clinical and Translational Radiation Oncology, Vol 27, Iss, Pp 15-23 (2021) |
| ISSN: | 2405-6308 |
| Popis: | Highlights • Complete resection is a potentially curative treatment for pancreatic cancer. • This report studies neoadjuvant chemotherapy with or without radiation. • The addition of radiation was associated with improved complete resection rates. • The addition of radiation was associated with improved pathologic down staging. Purpose Margin-negative (R0) resection is the only potentially curative treatment for patients with pancreatic ductal adenocarcinoma (PDAC). Pre-operative multi-agent chemotherapy alone (MAC) or MAC followed by pre-operative radiotherapy (MAC + RT) may be used to improve resectability and potentially survival. However, the optimal pre-operative regimen is unknown. Methods Patients with non-metastatic PDAC from 2006 to 2016 who received pre-operative MAC or MAC + RT before oncologic resection were identified in the National Cancer Database. Univariable and multivariable (MVA) associates with R0 resection were identified with logistic regression, and survival was analyzed secondarily with the Kaplan Meier method and Cox regression analysis. Results 4,599 patients were identified (MAC: 3,109, MAC + RT: 1,490). Compared to those receiving MAC, patients receiving MAC + RT were more likely to have cT3-4 disease (76% vs 64%, p |
| Databáze: | OpenAIRE |
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