International journal of radiation oncology, biology, physics · 2003
Neoadjuvant preoperative chemoradiation in patients with pancreatic cancer.
Клиническое исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Magnin Valerie, Moutardier Vincent, Giovannini Marie Helene, Lelong Bernard, Giovannini Marc, Viret Frederic, Monges Genevieve, Bardou Valerie Jeanne, Alzieu Claude, Delpero Jean Robert
Аннотация
PURPOSE: To assess the toxicity and efficacy of preoperative chemoradiation in pancreatic cancer.
METHODS AND MATERIALS: Between November 1996 and December 2001, 32 patients with biopsy-proven pancreatic adenocarcinoma (28 head; 4 body) were treated by chemoradiation consisting of either split-course therapy (two courses of 15 Gy separated by a 2-week break, n = 10) or standard-fractionation therapy (45 Gy during 5 weeks, n = 22). Concurrent chemotherapy included continuous infusion of 5-fluorouracil and a cisplatin bolus. Pancreatic resection was scheduled for 4-6 weeks after completion of chemoradiation treatment.
RESULTS: All 32 patients completed the chemoradiation protocol. Only 2 cases of Grade 3 toxicity (weight loss, vomiting) and one fatal Grade 4 infection occurred. Of the 32 patients, 19 underwent curative resection. Two patients had a complete pathologic response. One patient died 36 months after diagnosis of late treatment-related toxicity (acute superior mesenteric artery thrombosis) with no evidence of disease. The 2-year overall survival rate for the entire group and the resected patients was 37.3% (95% confidence interval 18.2-56.4%) and 59.3% (95% confidence interval 34.1-84.9%), respectively.
CONCLUSION: Preoperative chemoradiation with 5-fluorouracil and cisplatin is feasible and promising.
METHODS AND MATERIALS: Between November 1996 and December 2001, 32 patients with biopsy-proven pancreatic adenocarcinoma (28 head; 4 body) were treated by chemoradiation consisting of either split-course therapy (two courses of 15 Gy separated by a 2-week break, n = 10) or standard-fractionation therapy (45 Gy during 5 weeks, n = 22). Concurrent chemotherapy included continuous infusion of 5-fluorouracil and a cisplatin bolus. Pancreatic resection was scheduled for 4-6 weeks after completion of chemoradiation treatment.
RESULTS: All 32 patients completed the chemoradiation protocol. Only 2 cases of Grade 3 toxicity (weight loss, vomiting) and one fatal Grade 4 infection occurred. Of the 32 patients, 19 underwent curative resection. Two patients had a complete pathologic response. One patient died 36 months after diagnosis of late treatment-related toxicity (acute superior mesenteric artery thrombosis) with no evidence of disease. The 2-year overall survival rate for the entire group and the resected patients was 37.3% (95% confidence interval 18.2-56.4%) and 59.3% (95% confidence interval 34.1-84.9%), respectively.
CONCLUSION: Preoperative chemoradiation with 5-fluorouracil and cisplatin is feasible and promising.
Предметные рубрики MeSH
AdenocarcinomaAdultAgedAntineoplastic Combined Chemotherapy ProtocolsCisplatinCombined Modality TherapyDisease ProgressionDisease-Free SurvivalDose Fractionation, RadiationFeasibility StudiesFemaleFluorouracilFollow-Up StudiesHumansLiver NeoplasmsLung NeoplasmsMaleMesenteric Artery, SuperiorMiddle AgedNeoadjuvant TherapyPancreatectomyPancreatic NeoplasmsRadiotherapy, High-EnergySepsisSurvival AnalysisThrombosisTreatment Outcome