ArticleCancer reports (Hoboken, N.J.)2026
Effect of First-Line Chemotherapy Alone Versus First-Line Chemotherapy Plus Radiotherapy on Survival in Patients With Locally Advanced Pancreatic Cancer in the IMRT Era: A Retrospective Cohort Study.
Article in Cancer reports (Hoboken, N.J.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe role of intensity-modulated radiotherapy (IMRT) and novel combination chemotherapy regimens in locally advanced pancreatic cancer (LAPC) remains unclear. In this study, we focused on comparing survival between first-line chemotherapy alone and first-line chemotherapy plus IMRT in patients with LAPC.
methodsA total of 70 patients from Shandong Cancer Hospital and Institute were enrolled. The primary endpoint was progression-free survival (PFS). Survival outcomes were estimated by the Kaplan-Meier method and compared by the log-rank test, and the multivariate Cox proportional hazards model was used to estimate hazard ratios (HRs), 95% CIs, and independent prognostic factors.
resultsThe median PFS was 10.0 months in the chemotherapy alone group and 14.0 months in the chemotherapy plus IMRT group (p = 0.465). Patients who received chemotherapy alone had a median OS of 12.0 versus 21.0 months for patients who received chemotherapy plus IMRT (p = 0.156). The chemotherapy alone group had a disease control rate (DCR) of 33.33% (6 of 18), while the chemotherapy plus IMRT group had a DCR of 61.54% (32 of 52) (p = 0.038). The multivariate Cox regression model was used to adjust for potential prognostic factors. Shorter PFS was observed in men (p = 0.042), and those with a high serum level of CA 19-9 (p = 0.047). Similarly, shorter OS was significantly associated with men (p = 0.010) and a high serum level of CA 19-9 (p = 0.020). Grade 3-4 fatigue or asthenia, decreased appetite, neutrophil count decreased, AST increased, and ALT increased were predominant in the chemotherapy alone group.
conclusionThe combination of first-line chemotherapy and IMRT improves the DCR rate (p = 0.038) and was well tolerated. However, first-line chemotherapy plus IMRT had no significant difference in PFS (p = 0.465) and OS (p = 0.156) compared with chemotherapy alone.
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