Abstract
Purpose: In the era of intensity-modulation radiation therapy (IMRT), no prospective randomized trial has evaluated the efficacy of IMRT exclusively, such as concurrent chemoradiotherapy (CCRT), sequential induction chemotherapy followed by radiotherapy (CT-RT), and systemic chemotherapy (CT) alone, for treating unresectable pancreatic adenocarcinomas (PAs) without metastasis. Through propensity score matching, we designed a nationwide, population-based, head-to-head cohort study to determine the effects of various treatments on unresectable PAs. Patients and methods: We minimized the confounding effects of various treatment outcomes in patients with unresectable PAs from the Taiwan Cancer Registry database by dividing them as follows: group 1, CCRT; group 2, sequential CT-RT; group 3, nontreatment; and group 4, CT alone. Results: The matching process yielded a final cohort of 2960 patients (740 patients each in groups 1, 2, 3, and 4). In both univariate and multivariate Cox regression analyses, the adjusted hazard ratios (95% confidence interval) derived for the definitive CCRT and sequential CT-RT groups compared with the CT alone group were 0.443 (0.397–0.495) and 0.633 (0.568–0.705), respectively. Conclusions: A combination of IMRT and systemic CT for the treatment of unresectable PAs might increase survival compared with CT alone.
| Original language | English |
|---|---|
| Pages (from-to) | 326-332 |
| Number of pages | 7 |
| Journal | Radiotherapy and Oncology |
| Volume | 129 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Nov 1 2018 |
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Keywords
- Chemotherapy alone
- Concurrent chemoradiotherapy
- Pancreatic adenocarcinoma
- Sequential chemoradiotherapy
- Survival
ASJC Scopus subject areas
- Hematology
- Oncology
- Radiology Nuclear Medicine and imaging
Cite this
Intensity-modulated radiotherapy with systemic chemotherapy improves survival in patients with nonmetastatic unresectable pancreatic adenocarcinoma : A propensity score-matched, nationwide, population-based cohort study. / Lin, Yen Kuang; Hsieh, Mao Chih; Chang, Chia Lun; Chow, Jyh Ming; Yuan, Kevin Sheng Po; Wu, Alexander T.H.; Wu, Szu Yuan.
In: Radiotherapy and Oncology, Vol. 129, No. 2, 01.11.2018, p. 326-332.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intensity-modulated radiotherapy with systemic chemotherapy improves survival in patients with nonmetastatic unresectable pancreatic adenocarcinoma
T2 - A propensity score-matched, nationwide, population-based cohort study
AU - Lin, Yen Kuang
AU - Hsieh, Mao Chih
AU - Chang, Chia Lun
AU - Chow, Jyh Ming
AU - Yuan, Kevin Sheng Po
AU - Wu, Alexander T.H.
AU - Wu, Szu Yuan
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Purpose: In the era of intensity-modulation radiation therapy (IMRT), no prospective randomized trial has evaluated the efficacy of IMRT exclusively, such as concurrent chemoradiotherapy (CCRT), sequential induction chemotherapy followed by radiotherapy (CT-RT), and systemic chemotherapy (CT) alone, for treating unresectable pancreatic adenocarcinomas (PAs) without metastasis. Through propensity score matching, we designed a nationwide, population-based, head-to-head cohort study to determine the effects of various treatments on unresectable PAs. Patients and methods: We minimized the confounding effects of various treatment outcomes in patients with unresectable PAs from the Taiwan Cancer Registry database by dividing them as follows: group 1, CCRT; group 2, sequential CT-RT; group 3, nontreatment; and group 4, CT alone. Results: The matching process yielded a final cohort of 2960 patients (740 patients each in groups 1, 2, 3, and 4). In both univariate and multivariate Cox regression analyses, the adjusted hazard ratios (95% confidence interval) derived for the definitive CCRT and sequential CT-RT groups compared with the CT alone group were 0.443 (0.397–0.495) and 0.633 (0.568–0.705), respectively. Conclusions: A combination of IMRT and systemic CT for the treatment of unresectable PAs might increase survival compared with CT alone.
AB - Purpose: In the era of intensity-modulation radiation therapy (IMRT), no prospective randomized trial has evaluated the efficacy of IMRT exclusively, such as concurrent chemoradiotherapy (CCRT), sequential induction chemotherapy followed by radiotherapy (CT-RT), and systemic chemotherapy (CT) alone, for treating unresectable pancreatic adenocarcinomas (PAs) without metastasis. Through propensity score matching, we designed a nationwide, population-based, head-to-head cohort study to determine the effects of various treatments on unresectable PAs. Patients and methods: We minimized the confounding effects of various treatment outcomes in patients with unresectable PAs from the Taiwan Cancer Registry database by dividing them as follows: group 1, CCRT; group 2, sequential CT-RT; group 3, nontreatment; and group 4, CT alone. Results: The matching process yielded a final cohort of 2960 patients (740 patients each in groups 1, 2, 3, and 4). In both univariate and multivariate Cox regression analyses, the adjusted hazard ratios (95% confidence interval) derived for the definitive CCRT and sequential CT-RT groups compared with the CT alone group were 0.443 (0.397–0.495) and 0.633 (0.568–0.705), respectively. Conclusions: A combination of IMRT and systemic CT for the treatment of unresectable PAs might increase survival compared with CT alone.
KW - Chemotherapy alone
KW - Concurrent chemoradiotherapy
KW - Pancreatic adenocarcinoma
KW - Sequential chemoradiotherapy
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85050875617&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85050875617&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2018.07.012
DO - 10.1016/j.radonc.2018.07.012
M3 - Article
C2 - 30082144
AN - SCOPUS:85050875617
VL - 129
SP - 326
EP - 332
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
SN - 0167-8140
IS - 2
ER -