Impact of Adjuvant Chemoradiotherapy on Survival of Resected Pancreatic Adenocarcinoma Cancer: A Surveillance, Epidemiology and End Results (SEER) Analysis
BackgroundThe benefits of postoperative adjuvant chemoradiotherapy (CRT) for pancreatic cancer remain controversial. The purpose of this study is to determine if adjuvant CRT can improve the overall survival of postoperative pancreatic cancer patients compared to adjuvant chemotherapy (CT).MethodsPa...
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| Format: | Article |
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Frontiers Media S.A.
2021-07-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.651671/full |
| _version_ | 1818602643657850880 |
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| author | Xiaomao Shi Jin Peng Huangang Jiang Yu Gao Wenbo Wang Fuxiang Zhou Fuxiang Zhou |
| author_facet | Xiaomao Shi Jin Peng Huangang Jiang Yu Gao Wenbo Wang Fuxiang Zhou Fuxiang Zhou |
| author_sort | Xiaomao Shi |
| collection | DOAJ |
| description | BackgroundThe benefits of postoperative adjuvant chemoradiotherapy (CRT) for pancreatic cancer remain controversial. The purpose of this study is to determine if adjuvant CRT can improve the overall survival of postoperative pancreatic cancer patients compared to adjuvant chemotherapy (CT).MethodsPatients with resected pancreas adenocarcinoma were identified in the Surveillance, Epidemiology, and End Results (SEER) database (2004–2016). Multivariate Cox regression was used to determine the factors related to survival rate. Selection bias was reduced to a minimum through propensity matching analysis. Subgroup analyses by clinical characteristics were performed.ResultsThis study identified 10,097 patients who received adjuvant CT (n = 5,454) or adjuvant CRT (n = 4,643). On multivariate analysis, age, sex, tumor size, site, grade, stage, T stage, and lymph node metastasis were independent risk factors for OS. The basic clinical characteristics were well balanced after propensity matching. After propensity matching, CRT can improve the survival rate compared with CT [median OS: 22 months vs 23 months (HR, 0.928; 95% CI, 0.881–0.977; P = 0.004)]. Subgroup analysis indicated that the survival benefit of adjuvant chemoradiotherapy was more significant in patients with female (HR, 0.860; 95% CI, 0.798–0.926; P = 0.005 for interaction) or T3 (HR, 0.905; 95% CI, 0.855–0.957; P = 0.04 for interaction) or lymph nodes positive (HR, 0.883; 95% CI, 0.832–0.938; P = 0.005 for interaction).ConclusionAdjuvant CRT was associated with improved survival compared with adjuvant CT in patients with resection of pancreatic ductal adenocarcinoma. The benefit was more significant in patients with female or T3 or lymph nodes positive. |
| first_indexed | 2024-12-16T13:10:32Z |
| format | Article |
| id | doaj.art-a71efeb5497d4ab79be703f9b333ee44 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-16T13:10:32Z |
| publishDate | 2021-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-a71efeb5497d4ab79be703f9b333ee442022-12-21T22:30:38ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-07-011110.3389/fonc.2021.651671651671Impact of Adjuvant Chemoradiotherapy on Survival of Resected Pancreatic Adenocarcinoma Cancer: A Surveillance, Epidemiology and End Results (SEER) AnalysisXiaomao Shi0Jin Peng1Huangang Jiang2Yu Gao3Wenbo Wang4Fuxiang Zhou5Fuxiang Zhou6Department of Chemotherapy and Radiation Therapy, Zhongnan Hospital, Wuhan University, Wuhan, ChinaDepartment of Chemotherapy and Radiation Therapy, Zhongnan Hospital, Wuhan University, Wuhan, ChinaDepartment of Chemotherapy and Radiation Therapy, Zhongnan Hospital, Wuhan University, Wuhan, ChinaDepartment of Chemotherapy and Radiation Therapy, Zhongnan Hospital, Wuhan University, Wuhan, ChinaDepartment of Chemotherapy and Radiation Therapy, Zhongnan Hospital, Wuhan University, Wuhan, ChinaHubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital, Wuhan University, Wuhan, ChinaDepartment of Chemotherapy and Radiation Therapy, Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, ChinaBackgroundThe benefits of postoperative adjuvant chemoradiotherapy (CRT) for pancreatic cancer remain controversial. The purpose of this study is to determine if adjuvant CRT can improve the overall survival of postoperative pancreatic cancer patients compared to adjuvant chemotherapy (CT).MethodsPatients with resected pancreas adenocarcinoma were identified in the Surveillance, Epidemiology, and End Results (SEER) database (2004–2016). Multivariate Cox regression was used to determine the factors related to survival rate. Selection bias was reduced to a minimum through propensity matching analysis. Subgroup analyses by clinical characteristics were performed.ResultsThis study identified 10,097 patients who received adjuvant CT (n = 5,454) or adjuvant CRT (n = 4,643). On multivariate analysis, age, sex, tumor size, site, grade, stage, T stage, and lymph node metastasis were independent risk factors for OS. The basic clinical characteristics were well balanced after propensity matching. After propensity matching, CRT can improve the survival rate compared with CT [median OS: 22 months vs 23 months (HR, 0.928; 95% CI, 0.881–0.977; P = 0.004)]. Subgroup analysis indicated that the survival benefit of adjuvant chemoradiotherapy was more significant in patients with female (HR, 0.860; 95% CI, 0.798–0.926; P = 0.005 for interaction) or T3 (HR, 0.905; 95% CI, 0.855–0.957; P = 0.04 for interaction) or lymph nodes positive (HR, 0.883; 95% CI, 0.832–0.938; P = 0.005 for interaction).ConclusionAdjuvant CRT was associated with improved survival compared with adjuvant CT in patients with resection of pancreatic ductal adenocarcinoma. The benefit was more significant in patients with female or T3 or lymph nodes positive.https://www.frontiersin.org/articles/10.3389/fonc.2021.651671/fulladjuvant therapychemoradiotherapychemotherapypancreasradiotherapy |
| spellingShingle | Xiaomao Shi Jin Peng Huangang Jiang Yu Gao Wenbo Wang Fuxiang Zhou Fuxiang Zhou Impact of Adjuvant Chemoradiotherapy on Survival of Resected Pancreatic Adenocarcinoma Cancer: A Surveillance, Epidemiology and End Results (SEER) Analysis Frontiers in Oncology adjuvant therapy chemoradiotherapy chemotherapy pancreas radiotherapy |
| title | Impact of Adjuvant Chemoradiotherapy on Survival of Resected Pancreatic Adenocarcinoma Cancer: A Surveillance, Epidemiology and End Results (SEER) Analysis |
| title_full | Impact of Adjuvant Chemoradiotherapy on Survival of Resected Pancreatic Adenocarcinoma Cancer: A Surveillance, Epidemiology and End Results (SEER) Analysis |
| title_fullStr | Impact of Adjuvant Chemoradiotherapy on Survival of Resected Pancreatic Adenocarcinoma Cancer: A Surveillance, Epidemiology and End Results (SEER) Analysis |
| title_full_unstemmed | Impact of Adjuvant Chemoradiotherapy on Survival of Resected Pancreatic Adenocarcinoma Cancer: A Surveillance, Epidemiology and End Results (SEER) Analysis |
| title_short | Impact of Adjuvant Chemoradiotherapy on Survival of Resected Pancreatic Adenocarcinoma Cancer: A Surveillance, Epidemiology and End Results (SEER) Analysis |
| title_sort | impact of adjuvant chemoradiotherapy on survival of resected pancreatic adenocarcinoma cancer a surveillance epidemiology and end results seer analysis |
| topic | adjuvant therapy chemoradiotherapy chemotherapy pancreas radiotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.651671/full |
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