Document Detail

Concurrent radiotherapy and gemcitabine for unresectable pancreatic adenocarcinoma: impact of adjuvant chemotherapy on survival.
MedLine Citation:
PMID:  22019243     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To retrospectively analyze results of concurrent chemoradiotherapy (CCRT) using gemcitabine (GEM) for unresectable pancreatic adenocarcinoma.
METHODS AND MATERIALS: Records of 108 patients treated with concurrent external beam radiotherapy (EBRT) and GEM were reviewed. The median dose of EBRT in all 108 patients was 50.4 Gy (range, 3.6-60.8 Gy), usually administered in conventional fractionations (1.8-2 Gy/day). During radiotherapy, most patients received GEM at a dosage of 250 to 350 mg/m(2) intravenously weekly for approximately 6 weeks. After CCRT, 59 patients (54.6%) were treated with adjuvant chemotherapy (AC), mainly with GEM. The median follow-up for all 108 patients was 11.0 months (range, 0.4-37.9 months).
RESULTS: Initial responses after CCRT for 85 patients were partial response: 26 patients, no change: 51 patients and progressive disease: 8 patients. Local progression was observed in 35 patients (32.4%), and the 2-year local control (LC) rate in all patients was 41.9%. Patients treated with total doses of 50 Gy or more had significantly more favorable LC rates (2-year LC rate, 42.9%) than patients treated with total doses of less than 50 Gy (2-year LC rate, 29.6%). Regional lymph node recurrence was found in only 1 patient, and none of the 57 patients with clinical N0 disease had regional lymph node recurrence. The 2-year overall survival (OS) rate and the median survival time in all patients were 23.5% and 11.6 months, respectively. Patients treated with AC had significantly more favorable OS rates (2-year OS, 31.8%) than those treated without AC (2-year OS, 12.4%; p < 0.0001). On multivariate analysis, AC use and clinical T stage were significant prognostic factors for OS.
CONCLUSIONS: CCRT using GEM yields a relatively favorable LC rate for unresectable pancreatic adenocarcinoma, and CCRT with AC conferred a survival benefit compared to CCRT without AC.
Kazuhiko Ogawa; Yoshinori Ito; Naoki Hirokawa; Keiko Shibuya; Masaki Kokubo; Etsuyo Ogo; Hitoshi Shibuya; Tsutomu Saito; Hiroshi Onishi; Katsuyuki Karasawa; Kenji Nemoto; Yasumasa Nishimura;
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2011-10-20
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  83     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-14     Completed Date:  2012-07-31     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  559-65     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Department of Radiology, University of the Ryukyus, Okinawa, Japan.
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MeSH Terms
Adenocarcinoma / mortality,  pathology,  therapy*
Aged, 80 and over
Analysis of Variance
Antimetabolites, Antineoplastic / administration & dosage,  therapeutic use*
Chemoradiotherapy / methods*,  mortality
Chemotherapy, Adjuvant / mortality
Deoxycytidine / administration & dosage,  analogs & derivatives*,  therapeutic use
Drug Administration Schedule
Middle Aged
Pancreatic Neoplasms / mortality,  pathology,  therapy*
Radiation-Sensitizing Agents / administration & dosage,  therapeutic use*
Radiotherapy Dosage
Retrospective Studies
Tumor Burden
Reg. No./Substance:
0/Antimetabolites, Antineoplastic; 0/Radiation-Sensitizing Agents; 951-77-9/Deoxycytidine; B76N6SBZ8R/gemcitabine

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