The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.
Failure to Adhere to Protocol Specified Radiation Therapy Guidelines Was Associated With Decreased Survival in RTOG 9704—A Phase III Trial of Adjuvant Chemotherapy and Chemoradiotherapy for Patients With Resected Adenocarcinoma of the Pancreas
Open accessAbstract
Purpose In RTOG 9704, as previously published, patients with resected pancreatic adenocarcinoma received continuous infusion 5-FU and concurrent radiotherapy (5FU-RT). 5FU-RT treatment was preceded and followed by randomly assigned chemotherapy, either 5-FU or gemcitabine. This analysis explored whether failure to adhere to specified RT guidelines influenced survival and/or toxicity. Methods and Materials RT requirements were protocol specified. Adherence was scored as per protocol (PP) or less than per protocol (<PP). Scoring occurred following therapy but prior to trial analysis and without knowledge of individual patient treatment outcomes. Scoring was done for all tumor locations and for the subset of pancreatic head location. Results RT was scored for 416 patients: 216 PP and 200 <PP. For all pancreatic sites (head, body/tail) median survival (MS) for PP vs. <PP was 1.74 vs. 1.46 years (log-rank p=0.0077). In multivariate analysis, PP vs. <PP score correlated more strongly with MS than assigned treatment arm (p=0.014, p=NS, respectively); for patients with pancreatic head tumors, both PP score and gemcitabine treatment correlated with improved MS (p=0.016, p=0.043, respectively). For all tumor locations PP score was associated with decreased risk of failure (p=0.016) and, for gemcitabine patients, a trend toward reduced grade 4/5 non-hematologic toxicity (p=0.065). Conclusions This is the first phase III, multi-center, adjuvant protocol for pancreatic adenocarcinoma to evaluate the impact of adherence to specified RT protocol guidelines on protocol outcomes. Failure to adhere to specified RT guidelines was associated with reduced survival and, for patients receiving gemcitabine, trend toward increased non-hematologic toxicity.
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Lin, D., Lapen, K., Sherer, M. V., Kantor, J., Zhang, Z., Boyce, L. M., Bosch, W., Korenstein, D., & Gillespie, E. F. (2020) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2020.04.011 · Cited by 59
Metadata
- Authors
- Abrams, R. A., Winter, K. A., Regine, W. F., Safran, H., Hoffman, J. P., Lustig, R., Konski, A. A., Benson, A. B., Macdonald, J. S., Rich, T. A., & Willett, C. G.
- Venue
- International Journal of Radiation Oncology*Biology*Physics
- Publisher
- Elsevier BV
- Published
- 2012-02
- Volume
- 82
- Issue
- 2
- Pages
- 809-816
- ISSN
- 0360-3016 (ISSN-L)
- OpenAlex
- W2032111846
- Cited by
- 278
- References
- 29
- FWCI
- 8.41
- Type
- journal article
- Language
- en
- Open access
- green
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- Abrams, R. A., Winter, K. A., Regine, W. F., Safran, H., Hoffman, J. P., Lustig, R., Konski, A. A., Benson, A. B., Macdonald, J. S., Rich, T. A., & Willett, C. G. (2012). Failure to Adhere to Protocol Specified Radiation Therapy Guidelines Was Associated With Decreased Survival in RTOG 9704—A Phase III Trial of Adjuvant Chemotherapy and Chemoradiotherapy for Patients With Resected Adenocarcinoma of the Pancreas. International Journal of Radiation Oncology*Biology*Physics. https://doi.org/10.1016/j.ijrobp.2010.11.039
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