Effectiveness of Adjuvant Therapy in Patients with Pancreatic Cancer Who Underwent Neoadjuvant Therapy
Effectiveness of Adjuvant Therapy in Patients with Pancreatic Cancer Who Underwent Neoadjuvant Therapy
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DOI：
10.1245/s10434-021-09712-6
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发表时间：
2021-02-19
影响因子：
3.7
通讯作者：
Ohtsuka, Takao
中科院分区：
文献类型：
--
作者：
Kurahara, Hiroshi;Mataki, Yuko;Ohtsuka, Takao
目的新辅助治疗（NAT）不仅用于治疗晚期胰腺癌，也用于治疗可切除的胰腺癌。本研究探讨了胰腺癌患者接受手术切除后NAT. Methods谁接受了宏观根治性切除后NAT胰腺癌患者术后辅助化疗的有效性。辅助化疗定义为手术日期后3个月内至少1个周期的计划化疗，包括S-1、吉西他滨或两者。我们回顾性研究了辅助化疗对总生存期（OS）和无复发生存期（RFS）的影响，作为患者临床病理因素的函数。结果97例患者纳入研究，其中68例（70.1%）接受了辅助化疗。在NAT后糖链抗原19-9或杜克胰腺单克隆抗原2型水平升高但未恢复正常的患者中，辅助化疗与OS和RFS延长显著相关。在病理性淋巴结转移患者中，辅助化疗与OS延长显著相关，但未改善PFS。结论：根据肿瘤标志物表达判断，NAT治疗无效的胰腺癌患者术后辅助化疗与术后生存期延长相关。
Purpose Neoadjuvant therapy (NAT) is used to treat not only advanced pancreatic cancer but also resectable lesions. The present study investigated the effectiveness of postoperative adjuvant chemotherapy for patients with pancreatic cancer who underwent surgical resection after NAT. Methods Patients who underwent macroscopically curative resection after NAT for pancreatic cancer were enrolled. Adjuvant chemotherapy was defined as at least 1 cycle of planned chemotherapy within 3 months after the date of surgery and included S-1, gemcitabine, or both. We retrospectively examined the effect of adjuvant chemotherapy on overall survival (OS) and recurrence-free survival (RFS) as a function of patients' clinicopathological factors. Results Ninety-seven patients were included in the study, of which 68 (70.1%) underwent adjuvant chemotherapy. Administration of adjuvant chemotherapy was significantly associated with prolonged OS and RFS in patients whose elevated levels of carbohydrate antigen 19-9 or duke pancreatic monoclonal antigen type-2 did not normalize after NAT. In patients with pathological lymph node metastasis, the administration of adjuvant chemotherapy was significantly associated with longer OS but did not improve PFS. Conclusions Postoperative adjuvant chemotherapy was associated with prolonged postoperative survival in patients with pancreatic cancer who did not sufficiently respond to NAT as judged by tumor marker expression.