为了确定切除胰管腺癌（PDAC）患者围手术期化疗完成和相对剂量密度（RDI）的最佳阈值。许多接受PDAC胰腺切除术的患者未能启动或完成推荐的围手术期化疗。接受围手术期化疗的数量与总生存期（OS）之间的关联尚未明确。对于2010-2021年接受I/II期PDAC胰腺切除手术的225名患者进行单个机构的分析。分析了OS、化疗周期完成和相对剂量密度之间的关联。无论治疗顺序如何，完成≥ 67%的推荐周期与未接受化疗相比，与改善OS有关（中位OS：34.5 vs 18.1个月；HR = 0.43；95% CI：0.25-0.74），并且<67％的周期（中位OS：17.9个月；HR = 0.39；95% CI：0.24-0.64）。完成周期和RDI接收之间存在近线性关系（β = 0.82）。完成67％的周期相当于中位RDI为56％。接受≥56％ RDI相比未接受化疗（中位OS：35.5 vs 18.1；HR = 0.44；95％CI：0.23-0.84）和<56％ RDI（中位OS：27.2个月；HR = 0.44；95％CI：0.20-0.96）与改善OS有关。新辅助化疗与接受≥67％的推荐周期（OR = 2.94；95％CI：1.45-6.26）和≥56％的累积剂量密度（OR = 4.47；95％CI：1.72-12.50）的可能性增加相关。接受≥67%的推荐化疗周期或≥56%的累积RDI的PDAC患者具有改善的OS。新辅助治疗与接受≥67％的周期和≥56％的累积RDI的可能性增加相关，并且应考虑在所有可切除PDAC患者中使用。版权所有2023 Wolters Kluwer Health，Inc.。保留所有权利。

To define the optimal threshold of perioperative chemotherapy completion and relative dose intensity (RDI) for patients with resected pancreatic ductal adenocarcinoma (PDAC).Many patients who undergo pancreatectomy for PDAC fail to initiate or complete recommended perioperative chemotherapy. The association between the amount of perioperative chemotherapy received and overall survival (OS) is not well-defined.Single-institution analysis of 225 patients who underwent pancreatectomy for stage I/II PDAC (2010-2021). Associations between OS, chemotherapy cycles completed, and RDI were analyzed.Regardless of treatment sequence, completion of ≥67% of recommended cycles was associated with improved OS compared to no chemotherapy (median OS: 34.5 vs. 18.1 mo; HR=0.43; 95% CI: 0.25-0.74) and <67% of cycles (median OS: 17.9 mo; HR=0.39; 95% CI: 0.24-0.64). A near-linear relationship existed between cycles completed and the RDI received (β=0.82). A median RDI of 56% corresponded to completion of 67% of cycles. Receipt of ≥56% RDI was associated with improved OS compared to no chemotherapy (median OS: 35.5 vs. 18.1; HR=0.44; 95% CI: 0.23-0.84) and <56% RDI (median OS: 27.2 mo; HR=0.44; 95% CI: 0.20-0.96). Neoadjuvant chemotherapy associated with increased odds of receiving ≥67% of recommended cycles (OR=2.94; 95% CI: 1.45-6.26) and ≥56% RDI (OR=4.47; 95% CI: 1.72-12.50).Patients with PDAC who received ≥67% of recommended chemotherapy cycles or ≥56% cumulative RDI had improved OS. Neoadjuvant therapy was associated with increased odds of receiving ≥67% of cycles and ≥56% cumulative RDI and should be considered in all patients with resectable PDAC.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.