Document Details
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Document Type |
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Article In Journal |
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Document Title |
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Concurrent radiotherapy and gemcitabine for unresectable pancreatic adenocarcinoma: impact of adjuvant chemotherapy on survival Concurrent radiotherapy and gemcitabine for unresectable pancreatic adenocarcinoma: impact of adjuvant chemotherapy on survival |
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Document Language |
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English |
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Abstract |
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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. |
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ISSN |
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0360-3016 |
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Journal Name |
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International Journal of Radiation Oncology* Biology* Physics |
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Volume |
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83 |
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Issue Number |
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2 |
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Publishing Year |
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1433 AH
2012 AD |
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Article Type |
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Article |
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Added Date |
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Wednesday, March 9, 2016 |
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Researchers
| Kazuhiko Ogawa | Ogawa, Kazuhiko | Investigator | | kogawa@med.u-ryukyu.ac.jp |
| Yoshinori Ito | Ito, Yoshinori | Researcher | | |
| Naoki Hirokawa | Hirokawa, Naoki | Researcher | | |
| Keiko Shibuya | Shibuya, Keiko | Researcher | | |
| Masaki Kokubo | Kokubo, Masaki | Researcher | | |
| Etsuyo Ogo | Ogo, Etsuyo | Researcher | | |
| Hitoshi Shibuya | Shibuya, Hitoshi | Researcher | | |
| Tsutomu Saito | Saito, Tsutomu | Researcher | | |
| Hiroshi Onishi | Onishi, Hiroshi | Researcher | | |
| Katsuyuki Karasawa | Karasawa, Katsuyuki | Researcher | | |
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