Outcome of upfront combination chemotherapy followed by chemoradiation for locally advanced pancreatic adenocarcinoma
- 21 April 2009
- journal article
- clinical trial
- Published by Springer Science and Business Media LLC in Cancer Chemotherapy and Pharmacology
- Vol. 64 (6), 1253-1259
- https://doi.org/10.1007/s00280-009-0995-8
Abstract
The role and timing of chemotherapy and radiation for treating stage III pancreatic adenocarcinoma remains controversial. Treatment-naive patients with stage III non-resectable pancreatic adenocarcinoma were treated with PEFG/PEXG (cisplatin, epirubicin, 5-fluorouracil (F)/capecitabine (X), gemcitabine) or PDXG (docetaxel substituting epirubicin) regimen for 6 months followed by radiotherapy (50–60 Gy) with concurrent F or X or G. Ninety-one patients were registered between April 1997 and December 2007. Forty-three patients (47%) had a partial remission and 38 (42%) had a stable disease. Thirteen patients (14%) were radically resected yielding one pathologic complete remission. Median survival (OS) was 16.2 months. Median progression-free survival was 9.9 months. Pattern of failure consisted of isolated local failure (N = 26, 35%); both local and systemic failure (N = 14, 19%); isolated systemic failure (N = 35, 47%). Combination chemotherapy with four-drug regimens followed by chemoradiation was a feasible strategy showing relevant results in stage III pancreatic adenocarcinoma.Keywords
This publication has 25 references indexed in Scilit:
- Phase III trial comparing intensive induction chemoradiotherapy (60 Gy, infusional 5-FU and intermittent cisplatin) followed by maintenance gemcitabine with gemcitabine alone for locally advanced unresectable pancreatic cancer. Definitive results of the 2000–01 FFCD/SFRO studyAnnals Of Oncology, 2008
- A Phase II Study of Fixed-Dose Rate Gemcitabine Plus Low-Dose Cisplatin Followed by Consolidative Chemoradiation for Locally Advanced Pancreatic CancerInternational Journal of Radiation Oncology*Biology*Physics, 2007
- Systematic review, including meta-analyses, on the management of locally advanced pancreatic cancer using radiation/combined modality therapyBritish Journal of Cancer, 2007
- Concurrent gemcitabine and radiotherapy with and without neoadjuvant gemcitabine for locally advanced unresectable or resected pancreatic cancer: A phase I-II studyInternational Journal of Radiation Oncology*Biology*Physics, 2007
- Adjuvant Chemotherapy With Gemcitabine vs Observation in Patients Undergoing Curative-Intent Resection of Pancreatic CancerJAMA, 2007
- A Randomized Trial of Chemoradiotherapy and Chemotherapy after Resection of Pancreatic CancerNew England Journal of Medicine, 2004
- Treatment of Locally Unresectable Carcinoma of the Pancreas: Comparison of Combined-Modality Therapy (Chemotheraphy Plus Radiotherapy) to Chemotheraphy Alone1JNCI Journal of the National Cancer Institute, 1988
- Treatment of locally unresectable cancer of the stomach and pancreas: a randomized comparison of 5-fluorouracil alone with radiation plus concurrent and maintenance 5-fluorouracil--an Eastern Cooperative Oncology Group study.Journal of Clinical Oncology, 1985
- Therapy of locally unresectable pancreatic carcinoma: A randomized comparison of high dose (6000 rads) radiation alone, moderate dose radiation (4000 rads + 5-fluorouracil), and high dose radiation + 5-fluorouracil. The gastrointestinal tumor study groupCancer, 1981
- COMBINED 5-FLUOROURACIL AND SUPERVOLTAGE RADIATION THERAPY OF LOCALLY UNRESECTABLE GASTROINTESTINAL CANCERThe Lancet, 1969