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Background <p>The standard adjuvant chemotherapy for pancreatic ductal adenocarcinoma (PDAC) in Japan is S-1; however, the impact of dose reduction on prognosis remains unclear. We have reported that total dose intensity (TDI) ≥ 62.5% indicates good prognosis. This multicenter retrospective study evaluated the prognostic impact of TDI ≥ 62.5% and reduced dosing in patients who underwent radical resection for PDAC across three institutions.</p> Method <p>Patients were grouped into high-TDI (≥ 62.5%) and low-TDI (&lt; 62.5%) based on this cutoff. We performed an inverse probability of treatment weighting (IPTW)-adjusted analysis and calculated relapse-free survival (RFS) and overall survival (OS). OS was also calculated for high TDI with TDI &lt; 100% and TDI = 100%.</p> Result <p>Among 487 patients, 274 were included: 152 in the low-TDI and 122 in high-TDI groups. Patient background was adjusted using IPTW based on factors that might influence TDI. The median RFS for low- and high-TDI was 8 and 18&#xa0;months, respectively (p = 0.004). The median OS of low- and high-TDI groups was 20 and 50&#xa0;months, respectively (p &lt; 0.001). Among patients with high TDI, OS did not differ between those with TDI &lt; 100% and those with TDI = 100% (median, 47 vs. 72&#xa0;months, p = 0.208).</p> Conclusion <p>It has been suggested that a partial dose reduction of S-1 as adjuvant chemotherapy for PDAC does not significantly impact prognosis.</p>

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Prognostic impact of dose reduced S-1 adjuvant chemotherapy in patients with pancreatic ductal adenocarcinoma: a retrospective multicenter study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月26日

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  • Kazuki Kobayashi,
  • Takahiro Einama,
  • Yoichi Miyata,
  • Asuma Ide,
  • Naoto Yonamine,
  • Takazumi Tsunenari,
  • Mikiya Takao,
  • Masato Yamadera,
  • Makoto Nishikawa,
  • Akifumi Kimura,
  • Eiji Shinto,
  • Hideki Ueno,
  • Yoshifumi Beck,
  • Yoji Kishi

摘要

Background

The standard adjuvant chemotherapy for pancreatic ductal adenocarcinoma (PDAC) in Japan is S-1; however, the impact of dose reduction on prognosis remains unclear. We have reported that total dose intensity (TDI) ≥ 62.5% indicates good prognosis. This multicenter retrospective study evaluated the prognostic impact of TDI ≥ 62.5% and reduced dosing in patients who underwent radical resection for PDAC across three institutions.

Method

Patients were grouped into high-TDI (≥ 62.5%) and low-TDI (< 62.5%) based on this cutoff. We performed an inverse probability of treatment weighting (IPTW)-adjusted analysis and calculated relapse-free survival (RFS) and overall survival (OS). OS was also calculated for high TDI with TDI < 100% and TDI = 100%.

Result

Among 487 patients, 274 were included: 152 in the low-TDI and 122 in high-TDI groups. Patient background was adjusted using IPTW based on factors that might influence TDI. The median RFS for low- and high-TDI was 8 and 18 months, respectively (p = 0.004). The median OS of low- and high-TDI groups was 20 and 50 months, respectively (p < 0.001). Among patients with high TDI, OS did not differ between those with TDI < 100% and those with TDI = 100% (median, 47 vs. 72 months, p = 0.208).

Conclusion

It has been suggested that a partial dose reduction of S-1 as adjuvant chemotherapy for PDAC does not significantly impact prognosis.