BACKGROUND: The benefit and timing of radiation therapy (RT) for patients undergoing a resection for pancreatic adenocarcinoma remains unclear. This study identifies trends in the use of radiation over a 10-year period and factors associated with the use of pre-operative radiation, in particular. METHODS: The Surveillance, Epidemiology and End Results registry was used to identify patients aged ≥18 years with pancreatic adenocarcinoma who underwent a surgical resection between 2000 and 2010. Logistic regression was used to identify time trends and factors associated with the use of pre-operative radiation. RESULTS: The overall use of radiation decreased with time among the 8474 patients who met the inclusion criteria. However, the use of pre-operative radiation increased from 1.8% to 3.9% (P ≤ 0.05). Factors significantly associated with receipt of pre-operative radiation were younger age, treatment in more recent years and having an advanced T-stage tumour. The 5-year hazard of death was significantly less for those who received pre-operative radiation versus surgery alone [hazard ratio (HR) 0.64, 95% confidence interval (CI) 0.55-0.74] and for those who received post-operative radiation versus surgery alone (HR 0.69, 95% CI 0.65-0.73). DISCUSSION: The use of pre-operative radiation significantly increased during the study period. However, the overall use of pre-operative radiation therapy remains low in spite of the potential benefits.
BACKGROUND: The benefit and timing of radiation therapy (RT) for patients undergoing a resection for pancreatic adenocarcinoma remains unclear. This study identifies trends in the use of radiation over a 10-year period and factors associated with the use of pre-operative radiation, in particular. METHODS: The Surveillance, Epidemiology and End Results registry was used to identify patients aged ≥18 years with pancreatic adenocarcinoma who underwent a surgical resection between 2000 and 2010. Logistic regression was used to identify time trends and factors associated with the use of pre-operative radiation. RESULTS: The overall use of radiation decreased with time among the 8474 patients who met the inclusion criteria. However, the use of pre-operative radiation increased from 1.8% to 3.9% (P ≤ 0.05). Factors significantly associated with receipt of pre-operative radiation were younger age, treatment in more recent years and having an advanced T-stage tumour. The 5-year hazard of death was significantly less for those who received pre-operative radiation versus surgery alone [hazard ratio (HR) 0.64, 95% confidence interval (CI) 0.55-0.74] and for those who received post-operative radiation versus surgery alone (HR 0.69, 95% CI 0.65-0.73). DISCUSSION: The use of pre-operative radiation significantly increased during the study period. However, the overall use of pre-operative radiation therapy remains low in spite of the potential benefits.
Authors: J P Neoptolemos; J A Dunn; D D Stocken; J Almond; K Link; H Beger; C Bassi; M Falconi; P Pederzoli; C Dervenis; L Fernandez-Cruz; F Lacaine; A Pap; D Spooner; D J Kerr; H Friess; M W Büchler Journal: Lancet Date: 2001-11-10 Impact factor: 79.321
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Authors: H Golcher; T Brunner; G Grabenbauer; S Merkel; T Papadopoulos; W Hohenberger; T Meyer Journal: Eur J Surg Oncol Date: 2008-01-10 Impact factor: 4.424
Authors: William F Regine; Kathryn A Winter; Ross A Abrams; Howard Safran; John P Hoffman; Andre Konski; Al B Benson; John S Macdonald; Mahesh R Kudrimoti; Mitchel L Fromm; Michael G Haddock; Paul Schaefer; Christopher G Willett; Tyvin A Rich Journal: JAMA Date: 2008-03-05 Impact factor: 56.272
Authors: John P Neoptolemos; Deborah D Stocken; Helmut Friess; Claudio Bassi; Janet A Dunn; Helen Hickey; Hans Beger; Laureano Fernandez-Cruz; Christos Dervenis; François Lacaine; Massimo Falconi; Paolo Pederzoli; Akos Pap; David Spooner; David J Kerr; Markus W Büchler Journal: N Engl J Med Date: 2004-03-18 Impact factor: 91.245
Authors: Douglas B Evans; Gauri R Varadhachary; Christopher H Crane; Charlotte C Sun; Jeffrey E Lee; Peter W T Pisters; Jean-Nicolas Vauthey; Huamin Wang; Karen R Cleary; Gregg A Staerkel; Chusilp Charnsangavej; Elizabeth A Lano; Linus Ho; Renato Lenzi; James L Abbruzzese; Robert A Wolff Journal: J Clin Oncol Date: 2008-07-20 Impact factor: 44.544