SEER Database Analysis of Survival Impact of Early Adjuvant Radiotherapy (EART) for Resected Supratentorial Low-grade Glioma (SLGG) in Adults

Abstract Background: Neoadjuvant radiotherapy has been shown to improve marginal negative resection and local control of Pancreatic Ductal Adenocarcinoma (PDAC). However, whether it improves overall survival (OS) in patients with non-metastatic PDAC remains controversial. Therefore, the purpose of this study was to analyze the benefits of only surgery, neoadjuvant radiotherapy, adjuvant radiotherapy, and surgery plus chemotherapy for OS in patients with non-metastatic PDAC. Methods: PDAC diagnosed by surgical histopathology in the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016 was selected. Kaplan-Meier analysis was used to compare the prognosis of patients with different treatments. Cox proportional risk model was used to analyze independent predictors of OS.Propensity score matching (PSM) was used to analyze the tumor prognosis of different treatment methods. Results: Before PSM analysis, the OS of surgery plus chemotherapy (HRs = 0.896, 95%CIs, 0.827-0.970; P=0.007) were significantly better than the other three treatments for stage T1-3N0M0 PDAC patients. For stage T1-3N+M0 patients, adjuvant radiotherapy (HRs=0.613, 95% CIs, 0.579-0.649; P< 0.001) had significantly better OS than surgery plus chemotherapy and neoadjuvant radiotherapy. For stage T4N0M0 patients, neoadjuvant radiotherapy (HRs=0.482, 95% CIs, 0.347-0.670; P < 0.001) had significantly better OS than surgery plus chemotherapy and adjuvant radiotherapy. For stage T4N+M0 patients, neoadjuvant radiotherapy (HRs=0.338, 95% CIs, 0.215-0.532; P < 0.001) had significantly longer OS than adjuvant radiotherapy and surgery plus chemotherapy.Even after PSM, Chemotherapy plus surgery was still the best treatment for T1-3N0M0 patients. Postoperative adjuvant radiotherapy had the best prognosis among T1-3N+M0 patients, and neoadjuvant radiotherapy was the best treatment for T4 patients. Conclusions: For patients with non-metastatic PDAC, neoadjuvant radiotherapy, adjuvant radiotherapy and surgery plus chemotherapy were superior to only surgery in OS. For patients with stage T4 non-metastatic PDAC, neoadjuvant radiotherapy had the potential to be strongly recommended over adjuvant radiotherapy and surgery plus chemotherapy. However, neoadjuvant radiotherapy failed to benefit the survival of T1-3N0M0 stage patients, and surgery plus chemotherapy was preferred. For T1-3N+M0, neoadjuvant radiotherapy had no obvious advantage over adjuvant radiotherapy or surgery plus chemotherapy in OS, and adjuvant radiotherapy was more recommended.

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Effect of neoadjuvant radiotherapy on survival of non-metastatic Pancreatic Ductal Adenocarcinoma: A SEER Database Analysis

10.21203/rs.3.rs-21437/v1 ◽

2020 ◽

Author(s):

Dan Wang ◽

Chongshun Liu ◽

Tingyu Yan ◽

Chenglong Li ◽

Qionghui Yang ◽

...

Keyword(s):

Pancreatic Ductal Adenocarcinoma ◽

Adjuvant Radiotherapy ◽

Risk Model ◽

Ductal Adenocarcinoma ◽

Seer Database ◽

Database Analysis ◽

Neoadjuvant Radiotherapy ◽

Kaplan Meier ◽

Stage T1 ◽

Better Than

Abstract Background: Neoadjuvant radiotherapy has been shown to improve marginal negative resection and local control of Pancreatic Ductal Adenocarcinoma (PDAC). However, whether it improves overall survival (OS) in patients with non-metastatic PDAC remains controversial. Therefore, the purpose of this study was to analyze the benefits of only surgery, neoadjuvant radiotherapy, adjuvant radiotherapy, and surgery plus chemotherapy for OS in patients with non-metastatic PDAC. Methods: PDAC diagnosed by surgical histopathology in the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016 was selected. Kaplan-Meier analysis was used to compare the prognosis of patients with different treatments. Cox proportional risk model was used to analyze independent predictors of OS. Results: For stage T1-3N0M0 PDAC patients, the OS of surgery plus chemotherapy (HRs = 0.896, 95%CIs, 0.827-0.970; P=0.007) were significantly better than the other three treatments. For stage T1-3N+M0 patients, adjuvant radiotherapy (HRs=0.613, 95% CIs, 0.579-0.649; P< 0.001) had significantly better OS than surgery plus chemotherapy and neoadjuvant radiotherapy. For stage T4N0M0 patients, neoadjuvant radiotherapy (HRs=0.482, 95% CIs, 0.347-0.670; P < 0.001) had significantly better OS than surgery plus chemotherapy and adjuvant radiotherapy. For stage T4N+M0 patients, neoadjuvant radiotherapy (HRs=0.338, 95% CIs, 0.215-0.532; P < 0.001) had significantly longer OS than adjuvant radiotherapy and surgery plus chemotherapy. Conclusions: For patients with non-metastatic PDAC, neoadjuvant radiotherapy, adjuvant radiotherapy and surgery plus chemotherapy were superior to only surgery in OS. For patients with stage T4 non-metastatic PDAC, neoadjuvant radiotherapy had the potential to be strongly recommended over adjuvant radiotherapy and surgery plus chemotherapy. However, neoadjuvant radiotherapy failed to benefit the survival of T1-3N0M0 stage patients, and surgery plus chemotherapy was preferred. For T1-3N+M0, neoadjuvant radiotherapy had no obvious advantage over adjuvant radiotherapy or surgery plus chemotherapy in OS, and adjuvant radiotherapy was more recommended.

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The Use of Adjuvant Radiotherapy and Chemotherapy in Low Grade Glioma Patients in the United States from 2010-2016

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2020.07.2012 ◽

2020 ◽

Vol 108 (3) ◽

pp. e674-e675

Author(s):

W. Rehrer ◽

M. Rubens ◽

K. Von Werne ◽

Y. Odia ◽

M.D. Chuong ◽

...

Keyword(s):

United States ◽

Adjuvant Radiotherapy ◽

The United States ◽

Low Grade Glioma ◽

Low Grade

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The Role of Adjuvant Radiotherapy in the Outcome of Elderly Patients Treated with Surgery for Gallbladder Cancer: A SEER Database Analysis

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2011.06.552 ◽

2011 ◽

Vol 81 (2) ◽

pp. S357

Author(s):

D.P. Horowitz ◽

D. Gidea-Addeo ◽

C. Chao ◽

R.J. Burri

Keyword(s):

Elderly Patients ◽

Gallbladder Cancer ◽

Adjuvant Radiotherapy ◽

Seer Database ◽

Database Analysis

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RADT-31. PATTERNS OF CARE IN THE USE OF ADJUVANT RADIOTHERAPY AND CHEMOTHERAPY IN LOW GRADE GLIOMA PATIENTS IN THE UNITED STATES FROM 2010-2016

Neuro-Oncology ◽

10.1093/neuonc/noaa215.784 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii188-ii188

Author(s):

Warren Rehrer ◽

Yazmin Odia ◽

Muni Rubens ◽

Noah Kalman ◽

Michael Chuong ◽

...

Keyword(s):

Logistic Regression ◽

Adjuvant Radiotherapy ◽

Single Agent ◽

The United States ◽

Low Grade Glioma ◽

Subtotal Resection ◽

Low Grade ◽

Who Grade ◽

Trimodality Therapy ◽

Number Of Patients

Abstract PURPOSE In 2016, RTOG 9802 reported an overall survival advantage with the addition of chemotherapy to adjuvant radiotherapy (CRT) in patients with high-risk low grade glioma (LGG). We used the National Cancer Database (NCDB) to measure trends in CRT use in LGG patients from 2010-2016, a period when no Level 1 evidence existed. METHODS The NCDB was queried for WHO Grade II glioma patients treated from 2010-2016 who met the inclusion criteria for RTOG 9802. Adjusted logistic regression was used to assess the association of treatment year with the annual percentage of patients who received adjuvant CRT. Relative percent change and average annual percentage change (AAPC) were compared to determine if a change (defined a priori as < 0.01) occurred in the use of adjuvant CRT in LGG patients during this period. RESULTS The analytic cohort consisted of 5,039 patients; 64.3% of patients were 40 years or older and 35.7% were under 40 with subtotal resection. Use of adjuvant CRT increased from 18.9% to 49.7% (p< 0.001) during 2013-2016, with no change observed before 2013. The AAPC in the use of CRT was +39.6% per year (p< 0.001). Corresponding declines in patients treated with surgery alone (p< 0.001) and surgery plus radiotherapy (p< 0.001) were observed during 2013-2016. Logistic regression demonstrated patients who were under 40 years old were significantly less likely to receive adjuvant CRT than patients 40 years or older (Odds Ratio 0.561, 95% CI 0.475-0.663, p< 0.001). Use of adjuvant CRT increased from 12.5% to 45.1% in patients with oligodendroglioma during 2013-2016 (p< 0.001). CONCLUSIONS During 2013-2016, an increasing number of patients with LGG were treated with surgery followed by adjuvant CRT. Future studies may characterize the use of single agent vs. multiagent chemotherapy in this population and the adoption of trimodality therapy by mutation status.

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