TY - JOUR
T1 - The influence of adjuvant radiotherapy dose on overall survival in patients with resected pancreatic adenocarcinoma
AU - Hall, William A.
AU - Colbert, Lauren E.
AU - Liu, Yuan
AU - Gillespie, Theresa
AU - Lipscomb, Joseph
AU - Hardy, Claire
AU - Kooby, David A.
AU - Prabhu, Roshan S.
AU - Kauh, John
AU - Landry, Jerome C.
N1 - Funding Information:
The authors acknowledge support from the National Cancer Institute (Grants UO1 CA84244 and CA 89520). J-H Mao is the recipient of a Fellowship from the Leukemia and Lymphoma Society.
PY - 2013/6/15
Y1 - 2013/6/15
N2 - background Adjuvant radiotherapy (A-RT) for patients with resected pancreatic adenocarcinoma (PAC) is controversial. In the current study, the authors aim to determine whether there is an association between overall survival (OS) and A-RT dose. methods National Cancer Data Base (NCDB) data were obtained for all patients who received A-RT for resected PAC from 1998 through 2002. Univariate and multivariate survival analyses were performed along with Kaplan-Meier estimates for A-RT levels < 40 grays (Gy), 40 Gy to < 50 Gy, 50 Gy to < 55 Gy, and ≥ 55 Gy. results A total of 1385 patients met the inclusion criteria. The median age of the patients was 64 years (range, 29 years-87 years). All patients underwent surgical resection and A-RT with or without chemotherapy. A total of 231 patients were diagnosed with stage I disease, 273 were diagnosed with stage II disease, 734 were diagnosed with stage III disease, and 126 were diagnosed with stage IVA disease (according to the fifth edition of the American Joint Committee on Cancer); 21 were found to have an unknown stage of disease. The median A-RT dose was 45 Gy (range, 1.63 Gy-69 Gy). The median OS was 21 months (95% confidence interval [95% CI], 19 months-23 months). On multivariate analysis, an A-RT dose < 40 Gy (hazards ratio [HR], 1.30 [95% CI, 1.03-1.66]; P =.031), an A-RT dose of 40 Gy to < 50 Gy (HR, 1.17 [95% CI, 1.00-1.37]; P =.05), and an A-RT dose ≥ 55 Gy (HR, 1.44 [95% CI, 1.08-1.93]; P =.013) predicted worse OS compared with the reference category of 50 Gy to < 55 Gy. conclusions A-RT doses of < 40 Gy, 40 Gy to < 50 Gy, and ≥ 55 Gy were found to be associated with an inferior OS. The dose of A-RT delivered appears to influence OS and a prospective study evaluating the addition of optimally delivered A-RT for patients with resected PAC is needed.
AB - background Adjuvant radiotherapy (A-RT) for patients with resected pancreatic adenocarcinoma (PAC) is controversial. In the current study, the authors aim to determine whether there is an association between overall survival (OS) and A-RT dose. methods National Cancer Data Base (NCDB) data were obtained for all patients who received A-RT for resected PAC from 1998 through 2002. Univariate and multivariate survival analyses were performed along with Kaplan-Meier estimates for A-RT levels < 40 grays (Gy), 40 Gy to < 50 Gy, 50 Gy to < 55 Gy, and ≥ 55 Gy. results A total of 1385 patients met the inclusion criteria. The median age of the patients was 64 years (range, 29 years-87 years). All patients underwent surgical resection and A-RT with or without chemotherapy. A total of 231 patients were diagnosed with stage I disease, 273 were diagnosed with stage II disease, 734 were diagnosed with stage III disease, and 126 were diagnosed with stage IVA disease (according to the fifth edition of the American Joint Committee on Cancer); 21 were found to have an unknown stage of disease. The median A-RT dose was 45 Gy (range, 1.63 Gy-69 Gy). The median OS was 21 months (95% confidence interval [95% CI], 19 months-23 months). On multivariate analysis, an A-RT dose < 40 Gy (hazards ratio [HR], 1.30 [95% CI, 1.03-1.66]; P =.031), an A-RT dose of 40 Gy to < 50 Gy (HR, 1.17 [95% CI, 1.00-1.37]; P =.05), and an A-RT dose ≥ 55 Gy (HR, 1.44 [95% CI, 1.08-1.93]; P =.013) predicted worse OS compared with the reference category of 50 Gy to < 55 Gy. conclusions A-RT doses of < 40 Gy, 40 Gy to < 50 Gy, and ≥ 55 Gy were found to be associated with an inferior OS. The dose of A-RT delivered appears to influence OS and a prospective study evaluating the addition of optimally delivered A-RT for patients with resected PAC is needed.
KW - adjuvant radiation dose in resected pancreatic adenocarcinoma
KW - adjuvant radiotherapy
KW - pancreatic adenocarcinoma
KW - postoperative management in resected pancreatic adenocarcinoma
KW - resected pancreatic adenocarcinoma
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U2 - 10.1002/cncr.28047
DO - 10.1002/cncr.28047
M3 - Article
C2 - 23625519
AN - SCOPUS:84878590347
SN - 0008-543X
VL - 119
SP - 2350
EP - 2357
JO - Cancer
JF - Cancer
IS - 12
ER -