Comparing concurrent chemoradiotherapy, 125I seed implantation combined with chemotherapy, and chemotherapy alone efficacy in treating unresectable locally advanced pancreatic cancer

Abstract

Abstract Background The prognosis for unresectable locally advanced pancreatic cancer (LAPC) is still poor, and the best therapeutic option is still unknown. The common treatments for LAPC, concurrent chemoradiotherapy (CCRT), 125I seed implantation combined with chemotherapy (125IC), and chemotherapy alone (CA), were studied. In addition, we looked into the impact of radiation dose on the survival of patients receiving chemoradiotherapy. Methods This study included 202 patients with unresectable LAPC who were separated into three groups based on treatment methods: CCRT, 125IC, and CA. Overall survival (OS) and progression‐free survival (PFS) were calculated using the Kaplan‐Meier and Cox regression methods. The differences between groups were analyzed using the chi‐square test and the Fisher exact test. All three groups were compared at the same time and then in pairs. To investigate the impact of radiation dose on survival, patients with CCRT were divided into groups based on radiation dose (0.05). Multivariate analyses showed that age ≥ 64.5 years (p=0.038), ECOG score 2(p=0.001), and CCLRT (p=0.001) were significantly associated with poor OS, while being male (p=0.023) was associated with poor PFS. Conclusions Patients who received CCRT for unresectable LAPC had a greater OS rate than those who received 125IC or CA. Within permitted bounds, CCHRT outperformed CCLRT in terms of OS.

Keywords

• chemoradiotherapy
• chemotherapy
• 125I seed implantation
• radiation dose
• survival rate
• unresectable locally advanced pancreatic cancer