《Table 3 Differences in baseline characteristics between chemotherapy,chemoradiation therapy and che

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《Comparison of efficacy between adjuvant chemotherapy and chemoradiation therapy for pancreatic cancer: AJCC stage-based approach》

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The limitations of this study are as follows.First，there can be an inherent selection bias of a single-center retrospective study design.Due to the nature of the study，the baseline characteristics of the groups were different.Compared with other groups，the CRT-SCT group had a higher proportion of young patients and Eastern Cooperative Oncology Group performance status of zero with a lower proportion of patients with a free surgical margin≤1 mm.Patients with better performance status might have been selected for CRT-SCT，which could potentially bias the results in favor of CRT-SCT.Furthermore，it is now well known that radiation therapy increases the local recurrence-free survival in patients with a surgical margin≤1 mm.However，the proportion of these patients were highest in the SCT group，which may be a major selection bias.Second，the statistical power can be weak because the total number of patients was relatively small in this study.Moreover，because the incidence of tumor recurrence and death was few in stage I，we were statistically unable to further evaluate OS and RFS in stages I and II separately.Third，this study excluded patients treated with adjuvant chemotherapy with regimens other than FL or gemcitabine.Recently，modified FOLFIRINOX showed its superiority compared to gemcitabine alone in the adjuvant settings and is a preferred in fit patients.However，the use of modified FOLFIRINOX as an adjuvant treatment is limited in Korea because it has not been approved for reimbursement by the Korean healthcare system.Because this study is limited by a small number of patients and retrospective design，a welldesigned clinical trial that prospectively compares SCT and/or CRT should be followed.