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Preoperative chemoradiotherapy does not compromise the feasibility of adjuvant chemotherapy for patients with pancreatic ductal adenocarcinoma

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Abstract

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.

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Acknowledgments

We thank all of those who contributed samples, the surgeons and nursing staff, and the pathologists at Osaka University Hospital, Japan for providing precise pathological diagnoses.

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Authors and Affiliations

  1. Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan

    Hideo Tomihara, Hidetoshi Eguchi, Daisaku Yamada, Kunihito Gotoh, Koichi Kawamoto, Hiroshi Wada, Tadafumi Asaoka, Takehiro Noda, Yutaka Takeda, Masahiro Tanemura, Masaki Mori & Yuichiro Doki

  2. Department of Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan

    Yutaka Takeda

  3. Department of Surgery, Osaka Police Hospital, Osaka, Japan

    Masahiro Tanemura

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  1. Hideo Tomihara
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  2. Hidetoshi Eguchi
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Correspondence to Hidetoshi Eguchi.

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Hideo Tomihara and his co-authors have no conflicts of interest.

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Tomihara, H., Eguchi, H., Yamada, D. et al. Preoperative chemoradiotherapy does not compromise the feasibility of adjuvant chemotherapy for patients with pancreatic ductal adenocarcinoma. Surg Today 47, 218–226 (2017). https://doi.org/10.1007/s00595-016-1405-6

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  • DOI: https://doi.org/10.1007/s00595-016-1405-6

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