Background:

We aimed to study the impact of neoadjuvant chemotherapy to surgery (NCT-S) interval and neoadjuvant radiotherapy (NRT) on pathological complete response (pCR) and overall survival (OS) in pancreatic cancer (pancreatic ductal adenocarcinoma [PDAC]).

Methods:

National Cancer Data Base (NCDB)–pancreatectomy patients who underwent NCT/NRT were included. The NCT-S interval was divided into time quintiles in weeks: 8 to 11, 12 to 14, 15 to 19, 20 to 29, and >29 weeks.

Results:

A total of 2093 patients with NCT were included with median follow-up of 74 months and 71% NRT. The pCR rate was 2.1% with higher median OS compared with non-pCR (41 vs 19 months, P = .03). The pCR rate increased with longer NCT-S interval (quintiles: 1%, 1.6%, 1.7%, 3%, and 6%, P < .001, respectively). In logistic regression, NRT (odds ratio [OR] = 2.5, 95% confidence interval [CI]: 1.1-6.1, P = .03) and NCT-S >29 weeks (OR = 6.1, 95% CI = 2.02-18.50, P < .001) were predictive of increased pCR. The prolonged NCT-S interval and pCR were independent predictors of OS, whereas NRT was not.

Conclusions:

Longer NCT-S interval and pCR were independent predictors of improved OS in patients with PDAC. The NRT predicted increased pCR but not OS.

中文翻译：

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延长化疗对手术间隔和新辅助放疗对胰腺癌患者病理完全缓解和总生存期的影响。

背景：

我们旨在研究新辅助化疗至手术 (NCT-S) 间隔和新辅助放疗 (NRT) 对胰腺癌（胰腺导管腺癌 [PDAC]）病理完全缓解 (pCR) 和总生存期 (OS) 的影响。

方法：

纳入国家癌症数据库 (NCDB) - 接受 NCT/NRT 的胰腺切除术患者。NCT-S 间隔按周分为时间五分位数：8 至 11、12 至 14、15 至 19、20 至 29 和 >29 周。

结果：

共纳入 2093 名 NCT 患者，中位随访时间为 74 个月，NRT 率为 71%。与非 pCR 相比，pCR 率为 2.1%，中位 OS 更高（41 个月 vs 19 个月，P  = .03）。pCR 率随着 NCT-S 间期的延长而增加（五分位数分别为 1%、1.6%、1.7%、3% 和 6%，P  < .001）。在逻辑回归中，NRT（优势比 [OR] = 2.5，95% 置信区间 [CI]：1.1-6.1，P  = .03）和 NCT-S >29 周（OR = 6.1，95% CI = 2.02-18.50 , P  < .001) 预测 pCR 增加。延长的 NCT-S 间期和 pCR 是 OS 的独立预测因素，而 NRT 不是。

结论：

较长的 NCT-S 间期和 pCR 是 PDAC 患者 OS 改善的独立预测因素。NRT 预测 pCR 增加，但不预测 OS。