{"title":"减剂量S-1辅助化疗对胰腺导管腺癌患者预后的影响：一项回顾性多中心研究。","authors":"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","doi":"10.1007/s10147-025-02742-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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><p><strong>Method: </strong>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%.</p><p><strong>Result: </strong>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).</p><p><strong>Conclusion: </strong>It has been suggested that a partial dose reduction of S-1 as adjuvant chemotherapy for PDAC does not significantly impact prognosis.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1218-1228"},"PeriodicalIF":2.4000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122594/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prognostic impact of dose reduced S-1 adjuvant chemotherapy in patients with pancreatic ductal adenocarcinoma: a retrospective multicenter study.\",\"authors\":\"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\",\"doi\":\"10.1007/s10147-025-02742-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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><p><strong>Method: </strong>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%.</p><p><strong>Result: </strong>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).</p><p><strong>Conclusion: </strong>It has been suggested that a partial dose reduction of S-1 as adjuvant chemotherapy for PDAC does not significantly impact prognosis.</p>\",\"PeriodicalId\":13869,\"journal\":{\"name\":\"International Journal of Clinical Oncology\",\"volume\":\" \",\"pages\":\"1218-1228\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122594/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Clinical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10147-025-02742-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10147-025-02742-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/26 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Prognostic impact of dose reduced S-1 adjuvant chemotherapy in patients with pancreatic ductal adenocarcinoma: a retrospective multicenter study.
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.
期刊介绍：
The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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