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

Abstract

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. 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 40Gy radiation in 28 (G-CRT group), and as GEM, S-1, and 50.4Gy 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. 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. Preoperative CRT was demonstrated to be safe and did not compromise the feasibility of adjuvant chemotherapy.