文章：

吉西他滨联合S-1新辅助化疗对可切除胰腺导管腺癌患者的影响

Impact of Neoadjuvant Chemotherapy with Gemcitabine Plus S-1 in Patients with Resectable Pancreatic Ductal Adenocarcinoma

原文发布日期：10 October 2025

DOI: 10.3390/cancers17203287

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: Although neoadjuvant chemotherapy (NAC) is not universally recommended for resectable pancreatic ductal adenocarcinoma (PDAC), NAC with gemcitabine plus S-1 (NAC-GS) has become a commonly used regimen for resectable PDAC in Japan. Furthermore, the impact of achieving textbook outcomes (TO) in patients receiving NAC-GS remains unclear.Methods: This retrospective study included 265 patients who were diagnosed with resectable PDAC at our institution between January 2009 and December 2023. Patients were categorized into two groups: the NAC-GS group (n= 81; 2019–2023) and the upfront surgery (UFS) group (n= 164; 2009–2018). After comparing the clinical outcomes between groups, multivariate analyses for survival were performed. Additionally, outcomes stratified by the achievement of the modified TO were analyzed in the NAC-GS group.Results: The completion rate of NAC-GS was 90.1%. Patients in the NAC-GS group exhibited significantly longer survival than those in the UFS group (2-year recurrence-free survival: 61.4% vs. 37.9%,p< 0.01; 2-year overall survival: 83.2% vs. 61.2%,p< 0.01). Multivariate analyses identified lymph node metastasis, NAC-GS induction, and completion of adjuvant chemotherapy as factors significantly associated with improved survival. Moreover, among patients who received NAC-GS, those who achieved modified TO demonstrated significantly longer survival than those who did not.Conclusions: This study demonstrated the clinical efficacy of NAC-GS in patients with resectable PDAC. Induction of NAC-GS was significantly associated with improved long-term outcomes. In multidisciplinary treatment strategies for PDAC, achieving a modified TO may lead to improved survival of patients undergoing NAC-GS.

摘要翻译： 

**背景/目的：** 尽管新辅助化疗（NAC）并未被普遍推荐用于可切除的胰腺导管腺癌（PDAC），但在日本，吉西他滨联合S-1的新辅助化疗（NAC-GS）已成为可切除PDAC的常用方案。此外，在接受NAC-GS的患者中，达到教科书式结局（TO）的影响尚不明确。 **方法：** 这项回顾性研究纳入了2009年1月至2023年12月期间在我院诊断为可切除PDAC的265例患者。患者被分为两组：NAC-GS组（n=81；2019-2023年）和直接手术组（n=164；2009-2018年）。在比较组间临床结局后，进行了生存期的多变量分析。此外，在NAC-GS组中，还分析了按是否达到改良TO分层的结局。 **结果：** NAC-GS的完成率为90.1%。NAC-GS组患者的生存期显著长于直接手术组（2年无复发生存率：61.4% vs. 37.9%，p < 0.01；2年总生存率：83.2% vs. 61.2%，p < 0.01）。多变量分析确定淋巴结转移、NAC-GS诱导以及辅助化疗完成是与改善生存显著相关的因素。此外，在接受NAC-GS的患者中，达到改良TO的患者生存期显著长于未达到者。 **结论：** 本研究证实了NAC-GS在可切除PDAC患者中的临床疗效。NAC-GS诱导与改善长期结局显著相关。在PDAC的多学科治疗策略中，达到改良TO可能有助于改善接受NAC-GS患者的生存。

原文链接：

Impact of Neoadjuvant Chemotherapy with Gemcitabine Plus S-1 in Patients with Resectable Pancreatic Ductal Adenocarcinoma