Role of Adjuvant Chemoradiotherapy for Duodenal Cancer: A Single Center Experience.
Kim, Kyubo MD *; Chie, Eui Kyu MD *; Jang, Jin-Young MD +; Kim, Sun Whe MD +; Oh, Do-Youn MD ++; Im, Seock-Ah MD ++; Kim, Tae-You MD ++; Bang, Yung-Jue MD ++; Ha, Sung W. MD *,[S]
American Journal of Clinical Oncology.
35(6):533-536, December 2012.
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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/m2/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.
(C) 2012 by Lippincott Williams & Wilkins, Inc