alexa Early vs. Late Chemoradiation Therapy and the Postopera
ISSN: 2165-7092

Pancreatic Disorders & Therapy
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Research Article

Early vs. Late Chemoradiation Therapy and the Postoperative Interval to Adjuvant Therapy do not Correspond to Local Recurrence in Resected Pancreatic Cancer

Ajay A Patel1, Sairaman Nagarajan2, Eli D Scher3, Caitlin Schonewolf AB1,4, Sairam Balasubramanian1, Elizabeth Poplin5, Rebecca Moss5, David August6, Darren Carpizo6, Laleh Melstrom6and Salma K Jabbour1*
1Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, State University of New Jersey, USA
2Center on Genomics, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
3Rowan University School of Osteopathic Medicine, Stratford NJ, USA,
4Department of Radiation Oncology, University of Pennsylvania, Philadelphia PA, USA
5Department of Medicine, Division of Medical Oncology, Cancer Institute of New Jersey,USA
6Department of Surgery, Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick NJ, USA
Corresponding Author : Salma K Jabbour
Department of Radiation Oncology
Rutgers Cancer Institute of New Jersey
Rutgers, The State University of New Jersey
195 Little Albany Street New Brunswick
New Jersey 08901-1914, USA
Tel: +7322533939
Fax: 7322533952
E-mail: [email protected]
Received February 12, 2015; Accepted March 31, 2015; Published April 02, 2015
Citation: Patel A, Nagarajan S, Scher E, Schonewolf ABC, Balasubramanian S, et al. (2015) Early vs. Late Chemoradiation Therapy and the Postoperative Interval to Adjuvant Therapy do not Correspond to Local Recurrence in Resected Pancreatic Cancer. Pancreat Disord Ther 5:151. doi:10.4172/2165-7092.1000151
Copyright: © 2015 Patel AA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

Objective Standard postoperative therapy for pancreatic cancer consists of both chemotherapy alone and chemoradiation. We sought to investigate whether the sequence of chemotherapy and chemoradiation and overall time to initiation of adjuvant therapy would impact local vs. distant recurrence. Methods After Institutional Review Board approval, resected pancreas cancer patient charts were evaluated for medical background, surgical, pathological, chemoradiation (CRT), and follow-up. Local recurrence (LR) was defined as failures occurring in the postoperative bed and regional lymph nodes. Early vs. late CRT was defined by whether CRT was given early (within 1-2 cycles of adjuvant chemotherapy) or late in the course of adjuvant chemotherapy (after the 3rd cycle of chemotherapy). The postoperative interval variance was compared to LR factors such as progression-free survival (PFS) and overall survival (OS). Results Of the 34 eligible patients, 47% (n=16) underwent early CRT and 41% (n=14) underwent late CRT. 12% (n=14) did not undergo any induction chemotherapy. At median follow-up of 22 months, 53% (n=18) had metastases, 24% (n=8) had LR, and 24% (n=8) were disease free. Kaplan-Meier curves revealed that early vs. late CRT did not appear to significantly impact OS (p=0.63), PFS (p=0.085) or LR (p=0.19). Postoperative interval did not affect PFS (p=0.42) or OS (p=0.93). Conclusions Early vs. late CRT and the time to initiation of adjuvant therapy were not significantly associated with LR in patients with resected pancreatic cancer. Future prospective studies are required to determine if sequencing of chemotherapy, CRT, or the postoperative interval impact survival and patterns of recurrence.

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