Non-surgical pancreatic cancer: The role of radiotherapy in prolonging survival, A retrospective cohort study in the SEER database

Background: Limited research has compared external beam radiotherapy (RT) to non-RT in patients with non-surgical locally advanced pancreatic cancer (LAPC). Therefore, this study investigates the impact of RT on overall survival (OS) in patients with non-surgical LAPC in a real-world context. Methods: We conducted an analysis of patients with non-surgical LAPC using data from the Surveillance, Epidemiology, and End Results (SEER) database. This analysis involved the utilization of Kaplan-Meier survival curves and multivariable Cox regression analyses. Results: A total of 5,413 individuals with non-surgical LAPC were included in this analysis. Among them, 2,320 (42.9%) received RT, while 3,093 (57.1%) underwent non-RT treatment. The median OS was 12.0 months for the RT group and 9.0 months for the non-RT group, with a statistically significant difference ( P <0.001). Multivariate analysis revealed that RT had a statistically significant impact on OS (HR, 0.86; 95% CI, 0.81–0.91; P <0.001). Propensity score matching (PSM) analysis confirmed a statistically significant association of RT with improved OS (HR, 0.84, 95% CI, 0.79–0.90; P <0.001). These results remained consistent after conducting sensitivity analyses, subgroup analyses, and PSM. Conclusion: The study findings suggest that RT could be advantageous for patients with non-surgical LAPC. Further investigations are warranted to explore the relationship between RT and OS.