Survival Benefit of Post-Operative Radiotherapy in Patients with Resectable Pancreatic Head Adenocarcinoma

Background: Controversy still exis ts with regard to the beneficial effects of adjuvant radiotherapy (RT) on patients with resectable pancreatic head adenocarcinoma. The aim was to investigate the role of post-operative RT in resectable pancreatic head adenocarcinoma.Methods A total of 2092 patients with resectable pancreatic head adenocarcinoma were enrolled from 2004 to 2016. The data of these patients were obtained from the Surveillance, Epidemiology and End Results (SEER) database of the National Cancer Institute. The propensity score matching method was used to avoid selection bias of the treatment. A multivariable Cox proportional hazards model was used in analyzing the survival benefit from the utilization of post-operative RT.Results In total, 186 patients received post-operative RT after pancreatic head adenocarcinoma resection. Compared with patients who only underwent surgery (n = 1906), the subjects who had postoperative RT were younger (P = 0.000) and had a greater TNM stage (P = 0.00). The baseline characteristics of the two groups were well matched, and more notable in the clinicopathologic and demographic aspects. Before and after matching, the patients who received post-operative RT after pancreatic head adenocarcinoma resection had a higher survival rate than those who underwent only resection (P = 0.00). Subgroups analyses revealed that this benefit was restricted to patients with Lymph node invasion (P = 0.00).Conclusions Pancreatic head adenocarcinoma resection followed by post-operative RT demonstrated considerable survival benefit in relation to surgery alone.