Clinical observation of chemoradiotherapy in elderly patients with locally advanced pancreatic cancer
Objective To observe the efficacy and safety of chemoradiotherapy for locally advanced pancreatic cancer in patients over 65 years old.Methods Patients aged more than 65 years old with unresectable locally advanced pancreatic cancer in Zhongshan Hospital Affiliated to Fudan University from June 2019 to May 2023 were retrospectively analyzed.The efficacy and safety data of patients after treatment were sorted out through the hospital electronic medical record system,and the patients were followed-up regularly to obtain survival data.The short-term efficacy was evaluated according to the Response Evaluation Criteria for Solid Tumors(RECIST)1.1,and the safety was evaluated according to the Common Adverse Event Evaluation Criteria for Cancer in the United States(CTCAE)5.0.The survival curve was plotted by Kaplan-Meier method.The efficacy,adverse reactions and prognosis of the patients were analyzed.Results A total of 61 patients with locally advanced pancreatic cancer who met the inclusion criteria were included in the analysis.One month after the end of chemoradiotherapy,the short-term efficacy was evaluated with an objective response rate(ORR)of 12.9％and a disease control rate(DCR)of 81.5％.During the treatment,35 patients experienced treatment-related adverse events,and 13 patients experienced grade 3 treatment-related adverse events(all bone marrow suppression).All patients recovered smoothly after symptomatic supportive treatment.No patient experienced grade 4 or 5 treatment-related adverse events.The median follow-up time was 29.4 months.To the end of follow-up,11 patients maintained disease stability or remission,7 patients could not be evaluated,and 43 patients experienced disease progression.The median progression-free survival of the 61 patients was 12.2 months(95％CI:9.2-19.1 months),and the median overall survival was 22.5 months(95％CI:21.1-27.4 months).Conclusion For patients aged 65 years or older with locally advanced pancreatic cancer,chemoradiotherapy has significant efficacy and tolerable safety,and can be a potential ideal treatment for elderly patients with locally advanced pancreatic cancer.
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