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. 2015 Jun;17(6):542-50.
doi: 10.1111/hpb.12400. Epub 2015 Feb 28.

Trends in the use of pre-operative radiation for adenocarcinoma of the pancreas in the United States

Erin E Burke  1 , Schelomo Marmor  1   2 , Pamela R Portschy  1 , Beth A Virnig  2 , Lawrence C Cho  3 , Todd M Tuttle  1 , Eric H Jensen  1
Affiliations

Trends in the use of pre-operative radiation for adenocarcinoma of the pancreas in the United States

Erin E Burke et al. HPB (Oxford). 2015 Jun.

Abstract

Background: The benefit and timing of radiation therapy (RT) for patients undergoing a resection for pancreatic adenocarcinoma remains unclear. This study identifies trends in the use of radiation over a 10-year period and factors associated with the use of pre-operative radiation, in particular.

Methods: The Surveillance, Epidemiology and End Results registry was used to identify patients aged ≥18 years with pancreatic adenocarcinoma who underwent a surgical resection between 2000 and 2010. Logistic regression was used to identify time trends and factors associated with the use of pre-operative radiation.

Results: The overall use of radiation decreased with time among the 8474 patients who met the inclusion criteria. However, the use of pre-operative radiation increased from 1.8% to 3.9% (P ≤ 0.05). Factors significantly associated with receipt of pre-operative radiation were younger age, treatment in more recent years and having an advanced T-stage tumour. The 5-year hazard of death was significantly less for those who received pre-operative radiation versus surgery alone [hazard ratio (HR) 0.64, 95% confidence interval (CI) 0.55-0.74] and for those who received post-operative radiation versus surgery alone (HR 0.69, 95% CI 0.65-0.73).

Discussion: The use of pre-operative radiation significantly increased during the study period. However, the overall use of pre-operative radiation therapy remains low in spite of the potential benefits.

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Figures

Figure 1
Figure 1
Trends in the use of radiation therapy for resectable pancreatic adenocarcinoma from 2000 to 2010
Figure 2
Figure 2
Kaplan–Meier curves for overall survival based on the three treatment groups: surgery without radiation therapy (RT), pre-operative RT then surgery and surgery followed by post-operative RT
See this image and copyright information in PMC

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