Adjuvant radiotherapy and chemotherapy for pancreatic carcinoma: The Mayo Clinic experience (1975-2005)
Adjuvant radiotherapy and chemotherapy for pancreatic carcinoma: The Mayo Clinic experience (1975-2005)
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DOI：
10.1200/jco.2007.15.8782
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发表时间：
2008-07-20
影响因子：
45.3
通讯作者：
Gunderson, Leonard L.
中科院分区：
文献类型：
--
作者：
Corsini, Michele M.;Miller, Robert C.;Gunderson, Leonard L.
目的探讨胰腺癌切除后的预后因素及辅助化疗(CT)和放疗(RT)对总生存率(OS)的影响。患者与方法我们回顾了1975-2005年间在明尼苏达州罗切斯特市梅奥诊所接受完整切除的472例胰腺浸润性癌(T1-3N0-1M0)患者的临床资料。排除标准包括手术中转移或无法切除的疾病，手术切缘阳性，以及惰性肿瘤类型(胰岛细胞瘤和粘液性囊腺癌)。中位放疗剂量为50.4Gy28次；98%的放疗患者同时接受以氟尿嘧啶为基础的CT。结果6例患者在手术后30天内死亡。对于466名存活的患者，中位随访期为32.4个月；中位OS为21.6个月。接受CT-RT治疗后的中位OS为25.2个月，而不接受辅助治疗的患者为19.2个月(P=.001)。两年的操作系统分别为50%和39%，五年的操作系统分别为28%和17%。单因素和多因素分析确定的不良预后因素包括淋巴结阳性(风险比[RR]=1.3；P
PurposeTo determine prognostic factors and impact of adjuvant chemotherapy (CT) and radiotherapy (RT) on overall survival (OS) after resection of pancreatic adenocarcinoma.Patients and MethodsWe performed a retrospective review 472 consecutive patients who underwent complete resection with negative margins (RO) for invasive carcinoma (T1-3N0-1M0) of the pancreas between 1975 and 2005 at the Mayo Clinic in Rochester, MN. Exclusion criteria included metastatic or unresectable disease at surgery, positive surgical margins, and indolent tumor types (islet cell tumors and mucinous cystadenocarcinoma). Median RT dose was 50.4 Gy in 28 fractions; 98% of RT patients also received concurrent fluorouracil-based CT.ResultsSix patients died within 30 days of surgery. For the 466 surviving patients, median follow-up was 32.4 months; median OS was 21.6 months. Median OS after adjuvant CT-RT was 25.2 versus 19.2 months after no adjuvant therapy (P=.001). Two-year OS was 50% versus 39%, and 5-year OS was 28% versus 17%. Adverse prognostic factors identified by univariate and multivariate analysis included positive lymph nodes (risk ratio [RR] = 1.3; P