Evidence map›Paper›PMID 39893341›Full record

ArticleAnnals of surgical oncology2025

Neoadjuvant Chemoradiotherapy Using Moderately Hypofractionated Intensity-Modulated Radiotherapy Versus Upfront Surgery for Resectable Pancreatic Cancer: A Retrospective Cohort Study.

Kei Yamane, Takayuki Anazawa, Kazuyuki Nagai, Yosuke Kasai, Toshihiko Masui, Aya Izuwa, Koki Kurahashi, Satoshi Ishida, Satoshi Ogiso, Michio Yoshimura and 7 more

Abstract readComparative Study
In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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.

Kei YamaneDepartment of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Takayuki AnazawaDepartment of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. anazawa@kuhp.kyoto-u.ac.jp.
Kazuyuki NagaiDepartment of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Yosuke KasaiDepartment of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Toshihiko MasuiDepartment of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Aya IzuwaDepartment of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Koki KurahashiDepartment of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Satoshi IshidaDepartment of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Satoshi OgisoDepartment of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Michio YoshimuraDepartment of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Takahiro IwaiDepartment of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Junichi MatsubaraDepartment of Medical Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Akihisa FukudaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Hiroyoshi IsodaDepartment of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Yu HidakaDepartment of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Yumiko IbiDepartment of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Etsuro HatanoDepartment of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Funding

Japan Society for the Promotion of Science 23K15447
6 · The paper itself

Abstract

backgroundThe efficacy of neoadjuvant chemoradiotherapy for resectable pancreatic ductal adenocarcinoma (R-PDAC) remains unclear. This study was designed to evaluate neoadjuvant chemoradiotherapy by using intensity-modulated radiotherapy (NAC-IMRT) for R-PDAC compared with upfront surgery (UpS).

methodsAmong 198 patients with R-PDAC who were indicated for resection between 2013 and 2021, 130 were included in this study after excluding patients who underwent neoadjuvant chemotherapy and did not meet the NAC-IMRT criteria (Eligible set). NAC-IMRT was planned for 58 patients, and UpS was planned for 72 patients. Additionally, in 105 patients who could undergo the planned treatment (As-treated set), the surgical, pathological, and oncological outcomes were evaluated.

resultsIn the Eligible set, median overall survival (OS) was 50.5 months with NAC-IMRT and 34.7 months with UpS and progression-free survival was 20.4 months with NAC-IMRT and 13.9 months with UpS. In the As-treated set, OS was longer in the NAC-IMRT group (66.7 months vs. 34.7 months, p = 0.007). On multivariate analysis, NAC-IMRT was identified as an independent factor for better OS (hazard ratio 0.617, 95% confidence interval 0.382-0.995, p = 0.047, in the Eligible set). The incidence of postoperative complications did not show a difference between the two groups, and NAC-IMRT suppressed local tumor invasion, including lymphatic, venous, perineural invasion, and lymph node metastases.

conclusionsNAC-IMRT may offer superior survival outcomes and manageable toxicity in R-PDAC patients compared with upfront surgery. This study supports the efficacy and safety of NAC-IMRT and recommends its consideration in R-PDAC treatment protocols.

Indexed as

Carcinoma, Pancreatic DuctalChemoradiotherapy, AdjuvantNeoadjuvant TherapyPancreatectomyPancreatic NeoplasmsRadiation Dose HypofractionationRadiotherapy, Intensity-ModulatedAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective Studies

Identifiers

PMID39893341
PMCPMC11976822

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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.