PT  - JOURNAL ARTICLE
AU  - GIAN-CARLO MATTIUCCI
AU  - MASSIMO FALCONI
AU  - RUUD G.P.M. VAN STIPHOUT
AU  - SERGIO ALFIERI
AU  - FELIPE. A. CALVO
AU  - JOSEPH M. HERMAN
AU  - BERT W. MAIDMENT III
AU  - ROBERT C. MILLER
AU  - WILLIAM F. REGINE
AU  - MICHELE RENI
AU  - NAVESH SHARMA
AU  - STEFANO PARTELLI
AU  - DOMENICO GENOVESI
AU  - MARIO BALDUCCI
AU  - FRANCESCO DEODATO
AU  - VINCENZO VALENTINI
AU  - ALESSIO G. MORGANTI
TI  - Adjuvant Chemoradiation in Pancreatic Cancer: A Pooled Analysis in Elderly (≥75 years) Patients
DP  - 2015 Jun 01
TA  - Anticancer Research
PG  - 3441--3446
VI  - 35
IP  - 6
4099  - http://ar.iiarjournals.org/content/35/6/3441.short
4100  - http://ar.iiarjournals.org/content/35/6/3441.full
SO  - Anticancer Res2015 Jun 01; 35
AB  - Aim: To determine the impact of postoperative chemoradiation (POCR) on overall survival (OS) after resection of pancreatic adenocarcinoma (PAC) in elderly (≥75 years) patients. Materials and Methods: A multi-center retrospective review of 1248 patients who underwent complete resection with macroscopically negative margins (R0-1) for invasive PAC was performed. Exclusion criteria included age <75 years, metastatic or unresectable disease at surgery, macroscopic residual disease (R2), treatment with intraoperative radiotherapy (IORT) and postoperative death. Results: A total of 98 patients were included in the analysis (males=39.8%, females=60.2%; R1 resections=33.7%; pN1=61.2%); 63 patients received POCR and 26 patients received adjuvant chemotherapy alone. The median follow-up was 25.6 months. The mean age for the entire cohort of patients was 78.1±2.9 (SD) years. No differences were observed between patients receiving or not receiving POCR in terms of age (p=0.081), tumor diameter (p=0.412), rate of R1 resection (p=0.331) and incidence of lymph node-positive disease (p=0.078). The only factor predicting an improved OS was POCR. The median OS was 69.0 months in patients treated by POCR and 23.0 months in patients treated without POCR (p=0.008). Even by Cox multivariate analysis, the only significant predictor of OS was POCR (hazard ratio=0.449; 95% confidence interval=0.212-0.950; p=0.036). Conclusion: The study represents the first comparative approach on POCR in elderly patients after resection of PAC. OS was higher in patients who received POCR. Further analyses are warranted to evaluate the toxicity rate/grade and the impact of POCR on patient quality of life.