Abstract
Background: Currently, it is unclear whether chemotherapy or chemoradiotherapy (CRT) is the optimal first-line treatment for patients with locally advanced pancreatic adenocarcinoma. In this study, we compared the efficacy and safety of FOLFIRINOX (FFX), gemcitabine plus nab-paclitaxel (GnP), and CRT as first-line treatments for locally advanced pancreatic adenocarcinoma. Methods: We evaluated patients receiving FFX, GnP, or CRT, and assessed treatment efficacy in terms of overall survival and progression-free survival. Safety was evaluated using the Common Toxicity Criteria for Adverse Events (version 4.0). Results: Fifty-five patients were included in the analysis (10 for FFX, 25 for GnP, and 20 for CRT). The median overall survival was 7.1, 16.9, and 20.0 months in the FFX, GnP, and CRT groups, respectively. There was no significant difference in overall survival between the FFX and GnP groups (HR: 0.503, 95% CI: 0.205–1.238, p = 0.135), FFX and CRT groups (HR: 0.518, 95% CI: 0.213–1.256, p = 0.136), or GnP and CRT groups (HR: 0.993, 95% CI: 0.451–2.188, p = 0.987). The 1-year survival rates were 40%, 64%, and 60%, whereas the 2-year survival rates were 0%, 16%, and 35% in the FFX, GnP, and CRT groups, respectively. Conclusions: Both chemotherapy and CRT were effective and well tolerated. Thus, the combination of intensive chemotherapy and radiotherapy may be a beneficial treatment strategy.