%0 Journal Article
%T An Evaluation of Neoadjuvant Chemoradiotherapy for Patients with Resectable Pancreatic Ductal Adenocarcinoma
%A Hui Jiang
%A Chi Du
%A Mingwei Cai
%A Hai He
%A Cheng Chen
%A Jianguo Qiu
%A Hong Wu
%J HPB Surgery
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/298726
%X Aims. The aim of this study is to compare our results of preoperative chemotherapy followed by pancreaticoduodenectomy (PD) with those of surgery alone in patients with localized resectable pancreatic ductal adenocarcinoma (PDAC). Methods. Outcome data for 112 patients of resectable PDAC who received preoperative chemoradiotherapy followed by PD (group I) between January 2004 and April 2010 were retrospectively analyzed and were compared with selected 120 patients who underwent PD alone (group II) in the same period. Results. Patients in group I had an incidence of locoregional recurrence of 17.1% compared to 30.8% in group II ( ). There were no statistically significant differences in postoperative morbidity (27.7% versus 30.8%) and mortality (2.67% versus 3.33%). The 1-, 2-, and 3-year survival rates were estimated at 82.1%, 54%, and 28%, respectively, with NCRT and 65.8%, 29.1%, and 10% without ( ). Nevertheless, preoperative chemotherapy did not reduce the 1-, 3-, and 5-year disease-free survival rates, which were estimated at 58%, 36.6%, and 12.5% with NCRT and 51.7%, 18.3%, and 7.5% without ( ). Conclusions. The treatment of NCRT followed by PD in patients with PDAC has a significantly lower rate of locoregional recurrence and a longer overall survival than those with surgery alone. 1. Introduction Pancreatic ductal adenocarcinoma (PDAC) is a kind of remarkably highly lethal malignancy, foremost the 5th root cause of loss of life throughout the world [1]. Surgical resection has always been really the only most likely healing alternative. Even so, because of its ambitious tumor expansion as well as recurrence rate [2¨C4], in addition to the fact that a small section of patients are surgery candidates [5, 6], the actual survival rate of affected individuals is inadequate and simply ranges from 10% to 25.4% [7¨C10] at 5 years. The unsatisfying benefits of surgical treatment are only able to be enhanced by employing multidisciplinary treatments with adjuvant and neoadjuvant chemoradiotherapy (NCRT). The additional current publications revealed survival advantages for PDAC patients with the use of adjuvant therapy postoperatively. A meta-analysis has been carried out by Stocken et al. [11] in 2005 from 5 randomized controlled trails, which revealed a 25% diminishment in risk of death in those who obtained chemotherapy and substantial 2 years of survival rates for those who received chemoradiotherapy, in contrast to those who did not (38% versus 25%). Alternatively, up to 30% of individuals had been incapable to complete the course of adjuvant treatment
%U http://www.hindawi.com/journals/hpb/2013/298726/