Role of adjuvant chemoradiotherapy for duodenal cancer: a single center experience.

Abstract

OBJECTIVES:

To compare the treatment outcome of surgery alone with that of surgery followed by adjuvant chemoradiotherapy (CRT) for duodenal cancer.

METHODS:

Between January 1991 and December 2002, 24 patients with duodenal cancer underwent pancreaticoduodenectomy. There were 14 males and 10 females, and median age was 61 years (range, 33-75). Nine patients received adjuvant CRT, and 15 did not. Postoperative radiotherapy was delivered up to 40 Gy at 2 Gy/fraction with a 2-week planned rest. Intravenous 5-fluorouracil (500 mg/m/d) was given on days 1 to 3 of each split course. Median follow-up period was 32 months (range, 5-170).

RESULTS:

Nodal stage and stage group were more advanced in CRT (+) group (P=0.0894 and 0.0361, respectively). However, other patient and tumor characteristics were similar in each group. Five-year overall survival rates of CRT (-) and CRT (+) group were 47% and 30%, respectively (P=0.3799). Five-year locoregional relapse-free survival rates of CRT (-) and CRT (+) group were 64% and 80%, respectively (P=0.4188). On multivariate analysis, patients treated with adjuvant CRT had better locoregional relapse-free survival with borderline significance (P=0.0750). No patient suffered grade 3 or higher toxicity during CRT.

CONCLUSIONS:

Adjuvant CRT is feasible and may enhance locoregional control in advanced-staged duodenal cancer after curative resection.

• Authors: Kyubo Kim, Eui Kyu Chie, Jin-Young Jang, Sun Whe Kim, Do-Youn Oh, Seock-Ah Im, Tae-You Kim, Yung-Jue Bang, Sung W Ha
• Journal: American journal of clinical oncology (Am J Clin Oncol) Vol. 35 Issue 6 Pg. 533-6 (Dec 2012) ISSN: 1537-453X [Electronic] United States
• PMID: 21659832 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Antineoplastic Agents
• Fluorouracil

Topics

• Adenocarcinoma (secondary, therapy)
• Adenocarcinoma, Mucinous (secondary, therapy)
• Adult
• Aged
• Antineoplastic Agents (therapeutic use)
• Chemoradiotherapy, Adjuvant (adverse effects)
• Chi-Square Distribution
• Disease-Free Survival
• Dose Fractionation, Radiation
• Duodenal Neoplasms (pathology, therapy)
• Female
• Fluorouracil (therapeutic use)
• Follow-Up Studies
• Humans
• Kaplan-Meier Estimate
• Lymphatic Metastasis
• Maintenance Chemotherapy
• Male
• Middle Aged
• Neoplasm Invasiveness
• Neoplasm Recurrence, Local (pathology)
• Neoplasm Staging
• Pancreas (pathology)
• Pancreaticoduodenectomy
• Proportional Hazards Models
• Retrospective Studies