Neoplasma Vol.70, No.3, p. 468–475, 2023
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| Title: Chemotherapy versus chemoradiotherapy in borderline resectable and locally advanced pancreatic adenocarcinoma |
| Author: Soňa Argalácsová, Michal Vočka, Luboš Petruželka, Miroslav Ryska, Pavel Záruba, Zdeněk Krška, Vladimír Frýba, Jan Ulrych, Vladimír Černý, Tomáš Tůma, David Hoskovec |
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Abstract: The role of radiotherapy in borderline resectable (BRPC) and locally advanced pancreatic carcinoma (LAPC) remains controversial. In our study, we retrospectively evaluated 48 patients with BRPC (14; 29.2%) and LAPC (34; 70. 8%) who underwent 6–8 cycles of induction mFOLFIRINOX chemotherapy alone (23; 47.9%) or 4–6 cycles of mFOLFIRINOX followed by hypofractionated radiotherapy (up to the total dose of 39.9 Gy in 15 fractions) (25; 52.1%). Survival parameters were evaluated using the Gehan-Breslow-Wilcoxon Test and compared by using the long-rank test. The addition of radiotherapy was not associated with better survival (16.9 months for chemotherapy only versus 15.9 months for the combined therapy; p=0.486), as well as for both subgroups (13.5 months vs. 18.3 months; p=0.679) and (20.7 months vs. 13.8 months; p=0.425) for BRPC and LAPC, respectively. A higher resection rate was seen in the BRPC group compared to the LAPC group (43% vs. 17.6%, respectively). Our study revealed a significantly higher rate of lung metastases in patients after the combination therapy compared to those treated by chemotherapy only (19% vs. 0%, respectively; p=0.045). Such a borderline result, however, prevents us from drawing clear conclusions about whether this is an artifact caused by the low number of patients or whether radiotherapy leads to a selection of stem cells with a predilection to the generalization to the lungs.
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| Keywords: locally advanced; borderline resectable; pancreatic cancer; radiotherapy; induction chemotherapy |
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Published online: 25-Jul-2023
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| Year: 2023, Volume: 70, Issue: 3 |
Page From: 468, Page To: 475 |
doi:10.4149/neo_2023_230409N193
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