The choice of adjuvant radiotherapy in pancreatic cancer patients after up-front radical surgery.
The choice of adjuvant radiotherapy in pancreatic cancer patients after up-front radical surgery.
Blog Article
BackgroundThe role of adjuvant radiotherapy in pancreatic cancer following radical surgery remains a subject of of controversy.This study aimed to more accurately screen pancreatic patients who benefit from adjuvant radiotherapy.MethodsClinicopathologic characteristics of patients with resectable pancreatic cancer were collected from the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015).
Univariate and multivariate analyses were applied to identify prognostic factors affecting patient survival.All the patients were divided into two groups, one receiving radiation and the other not.Selection bias were reduced by propensity-score matching (PSM).
Kaplan-Meier analysis was used to estimate overall survival (OS) and cancer-specific survival (CSS) between the two groups.ResultsWithin 7097 patients, 2276 received adjuvant radiotherapy (external beam radiation), and 4821 did not.Multivariate analysis revealed that race, age, median income, sex, year of diagnosis, American Joint Committee on Cancer (AJCC) T stage, N stage, scope region lymph surgery, chemotherapy, and dodge warlord for sale radiotherapy were independent predictors for overall survival of all the patients (all p 0.
05).Among patients with N1 stage, the radiotherapy group exhibited a median overall survival (mOS) of 21 months (95% CI, 19.82 to 22.
18), while the non-radiotherapy group showed a slightly lower mOS of 18 months (95% CI, 16.88 to 19.12).
Similarly, in terms of median cancer-specific survival (mCSS), the radiotherapy group demonstrated a mCSS of 22 months (95% CI, 20.79 to 23.21), whereas the non-radiotherapy group had a slightly shorter mCSS of 19 months (95% CI, 17.
81 to 20.19).Radiotherapy reduced the all-cause mortality rate and cancer-specific mortality rate among patients with the N1 stage and T4 stage (all p ConclusionsOur analysis demonstrates that adjuvant radiotherapy may be beneficial for N1 stage (N+) 5326058hx pancreatic cancer patients who have undergone up-front radical surgery with T2-4 stage, primary focus on the head of the pancreas, young age of onset, and receiving combination chemotherapy.
However, radiotherapy needs to be used with caution in patients with T1 stage, N0 stage (N-), or primary focus on the body and tail of the pancreas.These findings may contribute to the development of personalized selection criteria for adjuvant radiotherapy in post-surgical pancreatic cancer patients.