In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 34, No. 4_suppl ( 2016-02-01), p. 370-370
Abstract:
370 Background: The patterns of failure after resection for duodenal cancer are very limited, and the benefit of adjuvant chemoradiotherapy has not been proven. We compared the treatment outcomes of surgery alone to those of surgery followed by adjuvant chemoradiotherapy (CRT) for duodenal cancer. Methods: Forty-seven patients with duodenal cancer underwent pancreaticoduodenectomy between January 1991 and February 2013. There were 33 males and 14 females, and their median age was 62 years (range, 31-80). Twenty-two patients (47%) received adjuvant CRT, and 25 (53%) did not. Postoperative radiotherapy was delivered to tumor bed and regional lymphatics (dose range = 40-55.4 Gy). All the patients underwent CRT concurrently with 5-fluorouracil. Median follow-up period was 31 months (range, 6-286). Results: Nodal stage and stage group were more advanced in CRT(+) group (p = 0.003 and 0.002, respectively). Locoregional recurrence (LRR) occurred in 11 patients; 8 out of 25 in CRT(-) and 3 out of 22 in CRT(+) group. Distant metastasis (DM) occurred in 19 patients; 7 out of 25 in CRT(-) and 12 out of 22 in CRT(+) group. Five patients experienced LRR and DM, and 3 of them were synchronous. Five-year overall survival rates of CRT(-) and CRT (+) group were 50% and 47%, respectively (p = 0.794). Five-year locoregional relapse-free survival rates of CRT(-) and CRT(+) group were 68% and 80%, respectively (p = 0.267). On multivariate analysis, the addition of CRT after curative resection was the only prognostic factor predicting superior locoregional relapse-free survival (p = 0.049). No patient suffered from grade 3 or higher toxicity during or after CRT. Conclusions: The addition of CRT after pancreaticoduodenectomy was associated with improvement of local control in duodenal cancer. Given the high LRR in surgery alone group, adjuvant CRT should be considered.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2016.34.4_suppl.370
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2016
detail.hit.zdb_id:
2005181-5
