Preoperative chemoradiotherapy does not compromise the feasibility of adjuvant chemotherapy for patients with pancreatic ductal adenocarcinoma.
PURPOSE
Preoperative chemoradiotherapy (CRT) is a novel, emerging treatment strategy for pancreatic ductal adenocarcinoma (PDAC), but it remains unclear whether post-surgery adjuvant chemotherapy is feasible following preoperative CRT. This retrospective study evaluates the feasibility of adjuvant therapy after preoperative CRT.


METHODS
The subjects of this study were 99 consecutive patients who underwent pancreatectomy for PDAC between January, 2007 and February, 2013 in our hospital. Sixty patients received preoperative CRT: as gemcitabine (GEM) and 40 Gy radiation in 28 (G-CRT group), and as GEM, S-1, and 50.4 Gy radiation in 32 (GS-CRT group). We also evaluated 39 patients who underwent surgery alone (SA group). We investigated adjuvant chemotherapy induction and completion rates and the frequency of adverse events rated ≥grade 3, based on Common Terminology Criteria for Adverse Events (version 4.0) in all three groups.


RESULTS
In the G-CRT, GS-CRT, and SA groups, the induction rates were 78 % (22/28), 78 % (25/32), and 72 % (28/39), respectively; completion rates were 86 % (19/22), 88 % (22/25), and 82 % (23/28), respectively; and adverse event frequencies were 36 % (8/22), 28 % (7/25), and 43 % (12/28), respectively. No significant difference was found among the three groups.


CONCLUSION
Preoperative CRT was demonstrated to be safe and did not compromise the feasibility of adjuvant chemotherapy.
['Tomihara|Hideo|H|', 'Eguchi|Hidetoshi|H|', 'Yamada|Daisaku|D|', 'Gotoh|Kunihito|K|', 'Kawamoto|Koichi|K|', 'Wada|Hiroshi|H|', 'Asaoka|Tadafumi|T|', 'Noda|Takehiro|T|', 'Takeda|Yutaka|Y|', 'Tanemura|Masahiro|M|', 'Mori|Masaki|M|', 'Doki|Yuichiro|Y|']
D000230:Adenocarcinoma D000368:Aged D000369:Aged, 80 and over D000971:Antineoplastic Combined Chemotherapy Protocols D021441:Carcinoma, Pancreatic Ductal D059186:Chemoradiotherapy, Adjuvant D017024:Chemotherapy, Adjuvant D003131:Combined Modality Therapy D003841:Deoxycytidine D004338:Drug Combinations D005240:Feasibility Studies D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D010094:Oxonic Acid D010180:Pancreatectomy D010190:Pancreatic Neoplasms D057234:Preoperative Period D011879:Radiotherapy Dosage D012189:Retrospective Studies D005641:Tegafur
Preoperative chemoradiotherapy Pancreatic ductal adenocarcinoma Adverse event Neoadjuvant chemotherapy