Abstract
Background and objective. To investigate the role of adjuvant radiotherapy in patients after surgical resection for pancreatic cancer. Methods and patients. The patients with pancreatic cancer from 18 registered institutions in the Surveillance Epidemiology and End Results (SEER) database were retrospectively analyzed. The characteristics of patients who would benefit from adjuvant radiotherapy were screened, as well as whether neoadjuvant or adjuvant radiotherapy conferred to a better clinical outcome. Results. 30249 patients included in this study (21295 vs 8954 in surgery and adjuvant radiotherapy group) .The median survivals in the surgery (S) group and adjuvant radiotherapy (S+R) group were 24 and 21 months respectively, The 1, 3, and 5-year overall survival (OS) rates in the S group and S+R group were 68%, 40%, 31% ,and 75%, 30%, 20%, respectively (p<0.001).Stratified analysis showed patients with histological classified as adenocarcinoma(15 VS 21, P<0.0001), infiltrating duct carcinoma (17 VS 21,P<0.0001), adenosquamous carcinoma(10 VS 18,P<0.0001) could be benefit from adjuvant radiotherapy. Adjuvant radiotherapy was helpful to improve the OS for patients with pancreatic head (19 VS 21, P=0.0003) and duct carcinoma (18VS 28, P=0.0121). Subgroup stratified assay indicated specific patients with early stage (AJCC 7th I, II, T2, N0) pancreatic carcinoma had better OS after additional radiotherapy than surgery alone. Conclusion. Additional radiotherapy may contribute to improved prognosis for patients with pancreatic carcinoma of specific histological types (adenocarcinoma/carcinoma, infiltrating duct carcinoma, adenosquamous carcinoma, and squamous), anatomical location, and advanced stage. A specific subgroup of patients with an early stage (I/II, T2) pancreatic cancer should be considered for additional radiotherapy.
Comparison of Outcomes and Prognostic Factors Between Early-Stage Cervical Adenocarcinoma and Adenosquamous Carcinoma Patients After Radical Surgery and Postoperative Adjuvant Radiotherapy