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Author Notes:

Correspondencer: William A. Hall, MD, 1365 Clifton Road NE, Atlanta, GA, 30322, Fax: 404-778-5593, Cell Phone: 404-354-7797, whall4@emory.edu

Disclosures: The authors made no disclosures.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Subjects:

Research Funding:

This work was supported in part by the National Center forAdvancing Translational Sciences of the National Institutes ofHealth under Award Number UL1TR000454 and TL1TR000456.

Keywords:

  • Pancreatic Adenocarcinoma adjuvant Radiation Therapy
  • Resected Pancreatic Adenocarcinoma
  • Post-operative management in resected pancreatic adenocarcinoma
  • Adjuvant radiation dose in resected pancreatic adenocarcinoma

The Influence of Adjuvant Radiation Therapy Dose on Overall Survival for Resected Pancreatic Adenocarcinoma

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Journal Title:

Cancer

Volume:

Volume 119, Number 12

Publisher:

, Pages 2350-2357

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background Adjuvant radiation therapy (A-RT) for resected pancreatic adenocarcinoma (PAC) is controversial. We aim to determine if there is an association between overall survival (OS) and A-RT dose. Methods National Cancer Data Base (NCDB) data were obtained for all patients who underwent A-RT for resected PAC from 1998-2002. Univariate (UV) and multivariable (MV) survival analysis were performed along with Kaplan-Meier (KM) estimates for A-RT levels < 40 Gy, 40 to < 50 Gy, 50 to < 55 Gy, and ≥ 55 Gy. Results 1,385 patients met inclusion criteria. Median age was 64 (29-87); all patients underwent surgical resection and A-RT +/- chemotherapy. 231 patients were AJCC 5th edition stage I, 273 stage II, 734 stage III, and 126 stage IVA; 21 were unknown. Median A-RT dose was 45 Gy (1.63 Gy-69 Gy). Median OS was 21 months (95% CI 19 - 23). On MV analysis A-RT dose < 40 Gy (HR, 1.30 [95% CI 1.03-1.66]; p = 0.031), A-RT dose 40 to < 50 Gy (HR, 1.17 [95% CI 1.00-1.37]; p = 0.05), and A-RT dose ≥ 55 Gy (HR, 1.44 [95% CI 1.08-1.93]; p = 0.013) predicted worse OS when compared with the reference category of 50 to < 55 Gy. Conclusions A-RT doses of less than 40 Gy, 40 to < 50 Gy, and ≥ 55 Gy were associated with inferior OS. The dose of A-RT delivered appears to influence OS and a prospective study evaluating the addition of optimally delivered A-RT for resected PAC is needed.

Copyright information:

© 2013 American Cancer Society

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