Network meta-analysis comparing neoadjuvant chemoradiation, neoadjuvant chemotherapy and upfront surgery in patients with resectable, borderline resectable, and locally advanced pancreatic ductal adenocarcinoma

Neoadjuvant chemoradiation or chemotherapy has improved the treatment efficacy of patients with resectable, borderline resectable, and locally advanced pancreatic ductal adenocarcinoma (PDAC). Due to the optimal regimen remains inconclusive, we aimed to compare these treatments in terms of margin ne...

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Bibliographic Details
Published in:Radiation oncology (London, England) England), 2019-07, Vol.14 (1), p.120-120, Article 120
Main Authors: Hu, Qiancheng, Wang, Dan, Chen, Ye, Li, Xiaofen, Cao, Peng, Cao, Dan
Format: Article
Language:English
Subjects:
Adenocarcinoma
Adjuvant chemotherapy
Analysis
Bayes Theorem
Bayesian analysis
Cancer treatment
Carcinoma, Pancreatic Ductal - pathology
Carcinoma, Pancreatic Ductal - therapy
Care and treatment
Chemoradiotherapy, Adjuvant - mortality
Chemotherapy
Clinical trials
Combined Modality Therapy
Humans
Meta-analysis
Neoadjuvant therapy
Neoadjuvant Therapy - mortality
Network Meta-Analysis
Pancreatectomy - mortality
Pancreatic cancer
Pancreatic ductal adenocarcinoma
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - therapy
Postoperative complications
Professional associations
Prognosis
Surgery
Survival Rate
Treatment Outcome
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Summary:Neoadjuvant chemoradiation or chemotherapy has improved the treatment efficacy of patients with resectable, borderline resectable, and locally advanced pancreatic ductal adenocarcinoma (PDAC). Due to the optimal regimen remains inconclusive, we aimed to compare these treatments in terms of margin negative (R0) resection rate and overall survival (OS) with Bayesian analysis. We reviewed literature titles and abstracts comparing three treatment strategies (neoadjuvant chemoradiation, neoadjuvant chemotherapy, and upfront surgery) in PubMed, Embase, Cochrane Library, the American Society of Clinical Oncology and ClinicalTrials.gov database from 2009 to 2018 to estimate relative odds ratios (ORs) for margin negative (R0) resection rate and hazard ratios (HRs) for overall survival (OS) in all include trials. A total of 14 literatures with 1056 patients were enrolled in this Bayesian analysis. In the pairwise meta-analysis from limited head-to-head studies, compared with neoadjuvant chemotherapy, neoadjuvant chemoradiation showed superior OS significantly (HR 0.8, 95% CI 0.60-0.99, p 
ISSN:1748-717X
1748-717X
DOI:10.1186/s13014-019-1330-0