主页 > 医药生命 >
【J Clin Oncol】胰腺癌的辅助放化疗：梅奥临床经
Purpose: To determine prognostic factors and impact of adjuvant chemotherapy (CT) and radiotherapy (RT) on overall survival (OS) after resection of pancreatic adenocarcinoma.
Patients and Methods: We performed a retrospective review 472 consecutive patients who underwent complete resection with negative margins (R0) 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.
Results: Six 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 < .001), high histologic grade (RR = 1.2; P < .001), and no adjuvant therapy (RR = 1.3; P < .001). Tumor extension beyond the pancreas was an adverse prognostic factor by univariate analysis alone (P = .03). Patients receiving adjuvant therapy had more adverse prognostic factors than those not receiving adjuvant therapy (P = .001).
Conclusion: This study represents one of the largest, single-institution, retrospective reviews of adjuvant therapy in patients after R0 resection of carcinoma of the pancreas. Overall survival was better in patients who received adjuvant CT-RT.
http://jco.ascopubs.org/cgi/content/abstract/26/21/3511 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 Adjuvant Radiotherapy and Chemotherapy for Pancreatic Carcinoma: The Mayo Clinic Experience (1975-2005)
胰腺癌的辅助放化疗：梅奥临床经验（1975-2005）
Purpose: To determine prognostic factors and impact of adjuvant chemotherapy (CT) and radiotherapy (RT) on overall survival (OS) after resection of pancreatic adenocarcinoma.
目的：探讨胰腺癌的预后因素与辅助放化疗对胰腺癌患者术后总的存活时间的影响
Patients and Methods: We performed a retrospective review 472 consecutive patients who underwent complete resection with negative margins (R0) 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.
临床资料和方法：我们回顾性分析了1975-2005年间美国明尼苏达州罗切斯特的梅奥诊疗中心的472例浸润性胰腺癌患者(TNM分期：T1-3N0-1M0)，他们经历过完整的肿瘤切除手术并且切缘无肿瘤细胞残留（R0）。排除标准：转移癌、无法手术切除的肿瘤患者、切缘有肿瘤细胞残留、
无痛性肿瘤（胰岛细胞瘤和粘液性囊腺癌）。平均放疗照射剂量为总共50.4Gy，分28次进行；98%的放疗患者还同时接受了氟尿嘧啶的化疗。
Results: Six 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 < .001), high histologic grade (RR = 1.2; P < .001), and no adjuvant therapy (RR = 1.3; P < .001). Tumor extension beyond the pancreas was an adverse prognostic factor by univariate analysis alone (P = .03). Patients receiving adjuvant therapy had more adverse prognostic factors than those not receiving adjuvant therapy (P = .001).
结果：6例患者死于手术后的30天内。在466例存活的患者中，平均随访时间为32.4个月，总的平均存活时间为（OS）21.6个月，其中接受过辅助放化疗的患者为25.2个月，而没有接受过放化疗的患者为19.2个月（P=0.01）。两者的两年存活时间百分比分别为50%与39%，五年存活时间百分比分别为28%与17%。经过单变量和多变量分析发现不利预后因素包括淋巴结转移（危险比RR=1.3，p<0.001），高度恶性的组织分化程度（RR=1.2，p<0.001），不接受辅助治疗（RR=1.3，p<0.001）。还包括仅由通过单变量分析发现的超过胰腺范围的肿瘤原发灶（p=0.03）。接受过辅助治疗的与没有接受辅助治疗的患者相比，存在更多的不利预后因素（p=0.001）。
阅读本文的人还阅读：
作者:admin@医学,生命科学 2011-08-14 05:14
医学,生命科学网