title: Preoperative chemoradiotherapy does not compromise the feasibility of adjuvant chemotherapy for patients with pancreatic ductal adenocarcinoma.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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 40 Gy radiation in 28 (G-CRT group), and as GEM, S-1, and 50.4 Gy 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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Preoperative CRT was demonstrated to be safe and did not compromise the feasibility of adjuvant chemotherapy.
authors: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors: Hideo
authors: H
authors: Tomihara
authors: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. heguchi@gesurg.med.osaka-u.ac.jp.
authors: Hidetoshi
authors: H
authors: Eguchi
authors: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors: Daisaku
authors: D
authors: Yamada
authors: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors: Kunihito
authors: K
authors: Gotoh
authors: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors: Koichi
authors: K
authors: Kawamoto
authors: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors: Hiroshi
authors: H
authors: Wada
authors: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors: Tadafumi
authors: T
authors: Asaoka
authors: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors: Takehiro
authors: T
authors: Noda
authors: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.|Department of Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.
authors: Yutaka
authors: Y
authors: Takeda
authors: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.|Department of Surgery, Osaka Police Hospital, Osaka, Japan.
authors: Masahiro
authors: M
authors: Tanemura
authors: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors: Masaki
authors: M
authors: Mori
authors: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors: Yuichiro
authors: Y
authors: Doki
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D021441:Carcinoma, Pancreatic Ductal / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000628:therapy*; D057234:Preoperative Period; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D005641:Tegafur / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine
keywords: Adverse event; Neoadjuvant chemotherapy; Pancreatic ductal adenocarcinoma; Preoperative chemoradiotherapy