{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:06:10Z","timestamp":1789563970219,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2021QH208"],"award-info":[{"award-number":["ZR2021QH208"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2021QH245"],"award-info":[{"award-number":["ZR2021QH245"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82303508"],"award-info":[{"award-number":["82303508"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82103632"],"award-info":[{"award-number":["82103632"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The role of intensity\u2010modulated radiotherapy (IMRT) and novel combination chemotherapy regimens in locally advanced pancreatic cancer (LAPC) remains unclear. In this study, we focused on comparing survival between first\u2010line chemotherapy alone and first\u2010line chemotherapy plus IMRT in patients with LAPC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 70 patients from Shandong Cancer Hospital and Institute were enrolled. The primary endpoint was progression\u2010free survival (PFS). Survival outcomes were estimated by the Kaplan\u2013Meier method and compared by the log\u2010rank test, and the multivariate Cox proportional hazards model was used to estimate hazard ratios (HRs), 95% CIs, and independent prognostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median PFS was 10.0\u2009months in the chemotherapy alone group and 14.0\u2009months in the chemotherapy plus IMRT group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.465). Patients who received chemotherapy alone had a median OS of 12.0 versus 21.0\u2009months for patients who received chemotherapy plus IMRT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.156). The chemotherapy alone group had a disease control rate (DCR) of 33.33% (6 of 18), while the chemotherapy plus IMRT group had a DCR of 61.54% (32 of 52) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038). The multivariate Cox regression model was used to adjust for potential prognostic factors. Shorter PFS was observed in men (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042), and those with a high serum level of CA 19\u20109 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047). Similarly, shorter OS was significantly associated with men (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010) and a high serum level of CA 19\u20109 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020). Grade 3\u20134 fatigue or asthenia, decreased appetite, neutrophil count decreased, AST increased, and ALT increased were predominant in the chemotherapy alone group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The combination of first\u2010line chemotherapy and IMRT improves the DCR rate (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038) and was well tolerated. However, first\u2010line chemotherapy plus IMRT had no significant difference in PFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.465) and OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.156) compared with chemotherapy alone.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.70531","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T08:29:56Z","timestamp":1775032196000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of First\u2010Line Chemotherapy Alone Versus First\u2010Line Chemotherapy Plus Radiotherapy on Survival in Patients With Locally Advanced Pancreatic Cancer in the\n                    <scp>IMRT<\/scp>\n                    Era: A Retrospective Cohort Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6155-7133","authenticated-orcid":false,"given":"Zihao","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Interventional Radiology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4259-7351","authenticated-orcid":false,"given":"Yaru","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9004-088X","authenticated-orcid":false,"given":"Ji","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Oncology The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute  Jinan P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9840-1133","authenticated-orcid":false,"given":"Dong\u2010Fang","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"issue":"5","key":"e_1_2_13_2_1","first-page":"794","article-title":"Trend Analysis on Morbidity and Mortality of Pancreatic Cancer in China, 2005\u20102015","volume":"42","author":"Cai J.","year":"2021","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jncc.2024.01.006"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21626"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.13027"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000000742"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(19)30404-2"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2021.0017"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2025.07.002"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.21037\/jgo.2018.03.07"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2021.01.055"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-018-1063-5"},{"issue":"1","key":"e_1_2_13_13_1","article-title":"Current Systemic Treatment Options for Advanced Pancreatic Cancer\u2010An Overview Article","volume":"14","author":"Domagala\u2010Haduch M.","year":"2026","journal-title":"Biomedicine"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.3330"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.3857\/roj.2018.00073"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-023-00856-2"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2021.0057"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17182959"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.70648"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737140.2022.2130895"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2023.08.055"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm-22-1417"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30060427"},{"issue":"5","key":"e_1_2_13_24_1","first-page":"603","article-title":"NCCN Guidelines Updates: Pancreatic Cancer","volume":"17","author":"Tempero M. A.","year":"2019","journal-title":"Journal of the National Comprehensive Cancer Network: JNCCN"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-021-01649-7"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2017.95"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/030089160709300110"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyaa198"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.34.8904"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.37.2532"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canrad.2010.10.001"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2023.7065"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.4324"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.21037\/apc.2018.07.03"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.currproblcancer.2020.100607"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-019-1275-3"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2025.08.003"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2014.11.043"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2021.06.002"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000867"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002753"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003284"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2022.40.16_suppl.4008"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00066-020-01680-2"}],"container-title":["Cancer Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.70531","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cnr2.70531","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.70531","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:25:38Z","timestamp":1789561538000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cnr2.70531"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":43,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/cnr2.70531"],"URL":"https:\/\/doi.org\/10.1002\/cnr2.70531","archive":["Portico"],"relation":{},"ISSN":["2573-8348","2573-8348"],"issn-type":[{"value":"2573-8348","type":"print"},{"value":"2573-8348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-06-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70531"}}