title: Postoperative external beam radiotherapy for resected pancreatic adenocarcinoma: impact of chemotherapy on local control and survival.
abstract: OBJECTIVE
  To analyze retrospectively the results of postoperative external beam radiotherapy (EBRT) for resected pancreatic adenocarcinoma.
  
  
  METHODS
  The records of 47 patients treated with gross complete resection (R0: 24 patients, R1: 23 patients) and post-operative EBRT were reviewed. The median dose of EBRT was 50 Gy (range, 12-60 Gy), and chemotherapy was used in 37 patients (78.7%). The median follow-up period for all 47 patients was 14.4 months (range, 0.9-67.9 months).
  
  
  RESULTS
  At the time of this analysis, 24 patients (51.1%) had disease recurrence. Local failure was observed in 10 patients (21.3%), and the 2-year local control (LC) rate in all patients was 68.7%. Patients treated with EBRT and chemotherapy had a significantly more favorable LC (2-year LC rate: 76.0%) than those treated with EBRT alone (2-year LC rate: 40%, p=0.0472). The median survival time and the 2-year actuarial overall survival (OS) in all 47 patients were 30.0 months and 54.5%, respectively. Patients treated with EBRT and chemotherapy had a significantly more favorable OS (2-year OS rate: 61.6%) than those treated with EBRT alone (2-year OS: 25.0%, p=0.0454). On univariate analysis, chemotherapy use alone had a significant impact on OS, and on multivariate analysis, chemotherapy use also was a significant prognostic factor. There were no late morbidities of NCI-CTC Grade 3 or greater.
  
  
  CONCLUSIONS
  Post-operative EBRT with chemotherapy yields a favorable LC rate for resected pancreatic adenocarcionoma, and EBRT combined with chemotherapy confers a survival benefit compared to EBRT alone.
authors.affiliation: Department of Radiology, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan. kogawa@med.u-ryukyu.ac.jp
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ogawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shibuya
authors.forename: Nobue
authors.initials: N
authors.lastname: Uchida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Onishi
authors.forename: Yoshishige
authors.initials: Y
authors.lastname: Okuno
authors.forename: Miyako
authors.initials: M
authors.lastname: Myojin
authors.forename: Masao
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Naoto
authors.initials: N
authors.lastname: Kanesaka
authors.forename: Keiko
authors.initials: K
authors.lastname: Shibuya
authors.forename: Sunao
authors.initials: S
authors.lastname: Tokumaru
authors.forename: Ryuta
authors.initials: R
authors.lastname: Sasamoto
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Karasawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Nemoto
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Nishimura
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D000368:Aged; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D011182:Postoperative Care; D012189:Retrospective Studies