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Outcome Analysis of Chemoradiation in Unresectable Pancreatic Cancer Focusing on Treatment Sequencing Strategy
- Outcome Analysis of Chemoradiation in Unresectable Pancreatic Cancer Focusing on Treatment Sequencing Strategy
- Koh, Hyeon Kang; Chie, Eui Kyu; Kim, Kyubo; Jang, Jin-Young; Kim, Sun Whe; Oh, Do-Youn; Im, Seock-Ah; Bang, Yung-Jue; Ha, Sung W.
- Ewha Authors
- SCOPUS Author ID
- Issue Date
- Journal Title
- ANTICANCER RESEARCH
- 0250-7005; 1791-7530
- vol. 36, no. 10, pp. 5455 - 5461
- Pancreatic cancer; chemoradiotherapy; chemotherapy; radiation dose
- INT INST ANTICANCER RESEARCH
- SCI; SCIE; SCOPUS
- Aim: To analyze the outcomes of patients with unresectable pancreatic cancer after chemoradiotherapy (CCRT), focusing on sequencing strategy. Patients and Methods: Data of 144 patients treated from January 1989 to December 2013 were retrospectively analyzed. Patients were divided into the scheduled group (N=27), salvage group (N=37) and upfront group (N=80) per CCRT and chemotherapy sequence. Results: With a median follow-up of 10.4 months (range=1.4-164.2), median overall survival (OS) was 13.5 months. Patients in the upfront group had inferior performance status and received a lower radiation dose (p=0.007 and p<0.001, respectively). Higher radiation dose (=45 Gy) was the sole prognosticator related with improved survival in multivariate (p=0.001) analysis, whereas treatment sequence was not a significant prognostic factor (p=0.409). Conclusion: No difference was found among tested sequencing strategies that were all well-tolerated, despite skewed distribution for performance and radiation dose. An upfront approach may be a viable option for patients with limited performance to undergo more active systemic chemotherapy.
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