Adjuvant chemoradiation in pancreatic cancer: A pooled analysis in elderly (≥75 years) patients

Gian Carlo Mattiucci, Massimo Falconi, Ruud G.P.M. Van Stiphout, Sergio Alfieri, Felipe A. Calvo, Joseph M. Herman, Bert W. Maidment, Robert C. Miller, William F. Regine, Michele Reni, Navesh Sharma, Stefano Partelli, Domenico Genovesi, Mario Balducci, Francesco Deodato, Vincenzo Valentini, Alessio G. Morganti

Research output: Contribution to journalReview article

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Abstract

Aim: To determine the impact of postoperative chemoradiation (POCR) on overall survival (OS) after resection of pancreatic adenocarcinoma (PAC) in elderly (≥75 years) patients. Materials and Methods: A multi-center retrospective review of 1248 patients who underwent complete resection with macroscopically negative margins (R0-1) for invasive PAC was performed. Exclusion criteria included age <75 years, metastatic or unresectable disease at surgery, macroscopic residual disease (R2), treatment with intraoperative radiotherapy (IORT) and postoperative death. Results: A total of 98 patients were included in the analysis (males=39.8%, females=60.2%; R1 resections=33.7%; pN1=61.2%); 63 patients received POCR and 26 patients received adjuvant chemotherapy alone. The median follow-up was 25.6 months. The mean age for the entire cohort of patients was 78.1±2.9 (SD) years. No differences were observed between patients receiving or not receiving POCR in terms of age (p=0.081), tumor diameter (p=0.412), rate of R1 resection (p=0.331) and incidence of lymph node-positive disease (p=0.078). The only factor predicting an improved OS was POCR. The median OS was 69.0 months in patients treated by POCR and 23.0 months in patients treated without POCR (p=0.008). Even by Cox multivariate analysis, the only significant predictor of OS was POCR (hazard ratio=0.449; 95% confidence interval=0.212-0.950; p=0.036). Conclusion: The study represents the first comparative approach on POCR in elderly patients after resection of PAC. OS was higher in patients who received POCR. Further analyses are warranted to evaluate the toxicity rate/grade and the impact of POCR on patient quality of life.

Original languageEnglish (US)
Pages (from-to)3441-3446
Number of pages6
JournalAnticancer Research
Volume35
Issue number6
Publication statusPublished - Jun 1 2015

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All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Mattiucci, G. C., Falconi, M., Van Stiphout, R. G. P. M., Alfieri, S., Calvo, F. A., Herman, J. M., ... Morganti, A. G. (2015). Adjuvant chemoradiation in pancreatic cancer: A pooled analysis in elderly (≥75 years) patients. Anticancer Research, 35(6), 3441-3446.