Interferon based adjuvant chemoradiation therapy improves survival after pancreaticoduodenectomy for pancreatic adenocarcinoma
Interferon based adjuvant chemoradiation therapy improves survival after pancreaticoduodenectomy for pancreatic adenocarcinoma
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DOI：
10.1016/s0002-9610(00)00369-x
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发表时间：
2000-05-01
影响因子：
3
通讯作者：
Traverso, LW
中科院分区：
文献类型：
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作者：
Nukui, Y;Picozzi, VJ;Traverso, LW
d背景：基于43%的2年生存率，胃肠道肿瘤研究组（GITSG）推荐对胰腺癌切除患者进行基于5-FU的辅助放化疗。在这里，我们报告了基于α-干扰素的新型辅助放化疗的GITSG方案的生存率提高方法：从1993年7月至1998年9月，33例胰头腺癌患者接受了胰头切除术（PD），随后继续进行辅助治疗（GITSG型，n = 16）或基于IFN α的（n = 17）通常在手术后6至8周之间给予。后一种方案包括剂量为4，500至5，400 cGy的外束照射（每5周25次）和同时三种药物化疗，包括（1）连续输注5-FU（200 mg/m2/天）;（2）每周静脉推注顺铂（30毫克/平方米（2）每天）和（3）干扰素α（3百万单位皮下每隔一天）在5周的辐射。然后进行两个6周疗程的5-FU连续输注（每天200 mg/m2，第9 - 14周和第17 - 22周）。复发和生存的危险因素进行了比较，为两个group.RESULTS：一个更先进的肿瘤分期观察IFN α治疗的患者（阳性节点和美国癌症联合委员会[AJCC] III期= 78%）比GITSG组（阳性节点和III期= 44%，P = 0.052）。IFN α组的a年总生存率（84%）优于GITSG组（54%）。平均随访26个月，在这两个队列，精算生存曲线显着有利于IFN α组（P = 0.04）。结论：与有限的患者数量，这个II期类型的试验表明，更好的生存干扰素组相比，GITSG组，即使干扰素组与移动广泛的肿瘤分期。干扰素组的2年生存率是迄今为止发表的胰腺癌切除术的最佳结果。干扰素/顺铂/5-FU为基础的辅助放化疗方案似乎是一个有前途的治疗谁经历了PD的胰头腺癌的患者。(C)2000年出版，Excerpta Medica，Inc.
dBACKGROUND: Based on a 2-year survival of 43%, the Gastrointestinal Tumor Study Group (GITSG) recommended adjuvant 5-FU-based chemoradiation for resected patients with adenocarcinoma of the pancreatic heed. Here we report improved survival over the GITSG protocol with a novel adjuvant chemoradiotherapy based on interferon-alpha (IFN alpha).METHODS: From July 1993 to September 1998, 33 patients with adenocarcinoma of the pancreatic head underwent panereaticoduodenectomy (PD) and subsequently went on to adjuvant therapy (GITSG-type, n = 16) or IFN alpha-based (n = 17) typically given between 6 and 8 weeks after surgery. The latter protocol consisted of external-beam irradiation at a dose of 4,500 to 5,400 cGy (25 fractions per 5 weeks) and simultaneous three-drug chemotherapy consisting of (1) continuous infusion 5-FU (200 mg/m(2) per day); (2) weekly intravenous bolus cisplatin (30 mg/m(2) per day); and (3) IFN alpha (3 million units subcutaneously every other day) during the 5 weeks of radiation. This was then followed by two 6-week courses of continuous infusion 5-FU (200 mg/m(2) per day, given weeks 9 to 14 and 17 to 22). Risk factor's for recurrence and survival were compared for the two groups.RESULTS: A more advanced tumor stage was observed in the IFN alpha-treated patients (positive nodes and American Joint Committee on Cancer [AJCC] stage III = 78%) than the GITSG group (positive nodes and stage III = 44%, P = 0.052). The a-year overall survival was superior in the IFN alpha cohort (84%) versus the GITSG group (54%). With a mean follow-up of 26 months in both cohorts, actuarial survival curves significantly favored the IFN alpha group (P = 0.04).CONCLUSIONS: With a limited number of patients, this phase II type trial suggests better survival in the interferon group as compared with the GITSG group even though the interferon group was associated with a move extensive tumor stage. The 2-year survival rate in the interferon group is the best published to date for resected pancreatic cancer. The interferon/cisplatin/5-FU-based adjuvant chemoradiation protocol appears to be a promising treatment for patients who have undergone PD for adenocarcinoma of the pancreatic head. (C) 2000 by Excerpta Medica, Inc.