Evidence map›Paper›PMID 35129721›Full record

ArticleAnnals of surgical oncology2022

Neoadjuvant Stereotactic Body Radiotherapy After Upfront Chemotherapy Improves Pathologic Outcomes Compared With Chemotherapy Alone for Patients With Borderline Resectable or Locally Advanced Pancreatic Adenocarcinoma Without Increasing Perioperative Toxicity.

Colin S Hill, Lauren M Rosati, Chen Hu, Wei Fu, Shuchi Sehgal, Amy Hacker-Prietz, Christopher L Wolfgang, Matthew J Weiss, Richard A Burkhart, Ralph H Hruban and 7 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
2.5field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 25 citations in OpenAlex.

  1. Article
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  4. Article
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  6. Locally Advanced Pancreas Cancer, Is There a Role for Surgery?The Surgical clinics of North America · 2024
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 7 institutions in 1 country.

Colin S Hill *Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Sidney Kimmel Cancer Center, Baltimore, MD, USA.
Lauren M Rosati *University of South Carolina School of Medicine, Columbia, SC, USA.
Chen HuDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Sidney Kimmel Cancer Center, Baltimore, MD, USA.
Wei FuDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Sidney Kimmel Cancer Center, Baltimore, MD, USA.
Shuchi SehgalPhiladelphia College of Osteopathic Medicine, Philadelphia, PA, USA.
Amy Hacker-PrietzDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Sidney Kimmel Cancer Center, Baltimore, MD, USA.
Christopher L WolfgangDepartment of Surgery, New York University Grossman School of Medicine, New York, NY, USA.
Matthew J WeissDepartment of Surgery, Zucker School of Medicine at Hofstra/Northwell, Lake Success, NY, USA.
Richard A BurkhartDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ralph H HrubanDepartment of Pathology, the Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ana De Jesus-AcostaDepartment of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Dung T LeDepartment of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Lei ZhengDepartment of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Daniel A LaheruDepartment of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Jin HeDepartment of Surgery, New York University Grossman School of Medicine, New York, NY, USA.
Amol K NarangDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Sidney Kimmel Cancer Center, Baltimore, MD, USA. Anarang2@jhmi.edu.
Joseph M HermanRadiation Medicine, Zucker School of Medicine at Hofstra/Northwell, Lake Success, NY, USA. Jherman1@northwell.edu.
Johns Hopkins University · USJohns Hopkins Medicine · USHofstra University · USNew York University · USSidney Kimmel Cancer Center · USPhiladelphia College of Osteopathic Medicine · USUniversity of South Carolina · US

Funding

Transforming Human Pancreatic Cancer Into An Immunologic DiseaseP01CA247886 · NCI · JOHNS HOPKINS UNIVERSITY · PI JAFFEE, ELIZABETH M. · 2021 to 2025
$12.7M
Targeting the Immunosuppressive Tumor Microenvironment of Pancreatic Cancer with a Neoadjuvant Platform Clinical TrialR01CA197296 · NCI · JOHNS HOPKINS UNIVERSITY · PI William Reece Burns, Eric Christenson · 2015 to 2026
$5.7M
NCI NIH HHS P01 CA247886NCI NIH HHS R01 CA197296
6 · The paper itself

Abstract

backgroundPatients with borderline resectable pancreatic cancer (BRPC) or locally advanced pancreatic cancer (LAPC) are at high risk of margin-positive resection. Neoadjuvant stereotactic body radiation therapy (SBRT) may help sterilize margins, but its additive benefit beyond neoadjuvant chemotherapy (nCT) is unclear. The authors report long-term outcomes for BRPC/LAPC patients explored after treatment with either nCT alone or nCT followed by five-fraction SBRT (nCT-SBRT).

methodsPatients with BRPC or LAPC from 2011 to 2016 who underwent resection after nCT alone or nCT-SBRT were retrospectively reviewed. Baseline characteristics were compared, and the propensity score with inverse probability weighting (IPW) was used to compare pathologic/survival outcomes.

resultsOf 198 patients, 76 received nCT, and 122 received nCT-SBRT. The nCT-SBRT cohort had a higher proportion of LAPC (53% vs 22%; p < 0.001). The duration of nCT was longer for nCT-SBRT (4.6 vs 2.9 months; p = 0.03), but adjuvant chemotherapy was less frequently administered (53% vs 67.1%; p < 0.001). Adjuvant radiation was administered to 30% of the nCT patients. The nCT-SBRT regimen more frequently achieved negative margins (92% vs 70%; p < 0.001), negative nodes (59% vs 42%; p < 0.001), and pathologic complete response (7% vs 0%; p = 0.02). In the multivariate analysis, nCT-SBRT remained associated with R0 resection (p < 0.001). The nCT-SBRT cohort experienced no significant difference in median overall survival (OS) (22.1 vs 24.5 months), local progression-free survival (LPFS) (13.5 vs. 15.4 months), or distant metastasis-free survival (DMFS) (11.7 vs 16.3 months) after surgery. After SBRT, 1-year OS was 77.0% and 2-year OS was 50.4%. Perioperative Claven-Dindo grade 3 or greater morbidity did not differ significantly between the nCT and nCT-SBRT cohorts (p = 0.81).

conclusionsDespite having more advanced disease, the nCT-SBRT cohort was still more likely to undergo an R0 resection and experienced similar survival outcomes compared with the nCT alone cohort.

Indexed as

AdenocarcinomaPancreatic NeoplasmsRadiosurgeryAntineoplastic Combined Chemotherapy ProtocolsHumansNeoadjuvant TherapyRetrospective Studies

Identifiers

PMID35129721
PMCPMC8933354
OpenAlexW4210919882

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.