Salvage chemoradiotherapy after primary chemotherapy for locally advanced pancreatic cancer: a single-institution retrospective analysis
Salvage chemoradiotherapy after primary chemotherapy for locally advanced pancreatic cancer: a single-institution retrospective analysis
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DOI：
10.1186/1471-2407-12-609
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发表时间：
2012-12-20
期刊：
影响因子：
3.8
通讯作者：
Itami, Jun
中科院分区：
文献类型：
--
作者：
Mayahara, Hiroshi;Ito, Yoshinori;Itami, Jun
背景资料：对于局部晚期胰腺癌（LAPC）初次化疗失败后补救性放化疗（CRT）的适应症尚无共识。在这里，我们报告了对LAPC初次化疗后接受补救CRT的患者的回顾性分析。本研究的主要目的是评价LAPC原发性化疗后补救CRT的疗效和安全性。方法：回顾性纳入2004年至2011年在作者所在机构接受LAPC原发性化疗失败后接受补救CRT的30例患者。所有患者均经病理证实为胰腺癌。结果：原发性化疗持续至病情进展或出现不可接受的毒性。最终，26例患者（87%）因局部肿瘤进展而停止主要化疗，而4例患者（13%）因吉西他滨引起的间质性肺炎而停止化疗。在开始化疗后中位7.9个月，30例患者接受了补救CRT联合S-1或5-FU。毒性通常为轻度和自限性。从挽救性CRT开始的中位生存时间（MST）为8.8个月。6个月、1年和2年生存率分别为77%、33%和26%。多因素分析显示，CRT前血清CA 19-9水平较低（
Background: There is no consensus on the indication for salvage chemoradiotherapy (CRT) after failure of primary chemotherapy for locally advanced pancreatic cancer (LAPC). Here we report on the retrospective analysis of patients who received salvage CRT after primary chemotherapy for LAPC. The primary objective of this study was to evaluate the efficacy and safety of salvage CRT after primary chemotherapy for LAPC.Methods: Thirty patients who underwent salvage CRT, after the failure of primary chemotherapy for LAPC, were retrospectively enrolled from 2004 to 2011 at the authors' institution. All the patients had histologically confirmed pancreatic adenocarcinoma.Results: Primary chemotherapy was continued until progression or emergence of unacceptable toxicity. Eventually, 26 patients (87%) discontinued primary chemotherapy because of local tumor progression, whereas four patients (13%) discontinued chemotherapy because of interstitial pneumonitis caused by gemcitabine. After a median period of 7.9 months from starting chemotherapy, 30 patients underwent salvage CRT combined with either S-1 or 5-FU. Toxicities were generally mild and self-limiting. Median survival time (MST) from the start of salvage CRT was 8.8 months. The 6 month, 1-year and 2-year survival rates from the start of CRT were 77%, 33% and 26%, respectively. Multivariate analysis revealed that a lower pre-CRT serum CA 19-9 level (