Neoadjuvant chemoradiation with Gemcitabine for locally advanced pancreatic cancer

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Daniel Habermehl - , Universität Heidelberg (Autor:in)
  • Kerstin Kessel - , Klinik und Poliklinik für Strahlentherapie und Radioonkologie (Autor:in)
  • Thomas Welzel - , Klinik und Poliklinik für Strahlentherapie und Radioonkologie (Autor:in)
  • Holger Hof - , Klinik und Poliklinik für Strahlentherapie und Radioonkologie (Autor:in)
  • Amir Abdollahi - , Klinik und Poliklinik für Strahlentherapie und Radioonkologie (Autor:in)
  • Frank Bergmann - , Universitätsklinikum Heidelberg (Autor:in)
  • Stefan Rieken - , Klinik und Poliklinik für Strahlentherapie und Radioonkologie (Autor:in)
  • Jürgen Weitz - , Universitätsklinikum Heidelberg (Autor:in)
  • Jens Werner - , Universitätsklinikum Heidelberg (Autor:in)
  • Peter Schirmacher - , Universitätsklinikum Heidelberg (Autor:in)
  • Markus W. Büchler - , Universitätsklinikum Heidelberg (Autor:in)
  • Jürgen Debus - , Klinik und Poliklinik für Strahlentherapie und Radioonkologie (Autor:in)
  • Stephanie E. Combs - , Klinik und Poliklinik für Strahlentherapie und Radioonkologie (Autor:in)

Abstract

Introduction: To evaluate efficacy and secondary resectability in patients with locally advanced pancreatic cancer (LAPC) treated with neoadjuvant chemoradiotherapy (CRT).Patients and methods: A total of 215 patients with locally advanced pancreatic cancer were treated with chemoradiation at a single institution. Radiotherapy was delivered with a median dose of 52.2 Gy in single fractions of 1.8 Gy. Chemotherapy was applied concomitantly as gemcitabine (GEM) at a dose of 300 mg/m 2 weekly, followed by adjuvant cycles of full-dose GEM (1000 mg/m 2). After neoadjuvant CRT restaging was done to evaluate secondary resectability. Overall and disease-free survival were calculated and prognostic factors were estimated.Results: After CRT a total of 26% of all patients with primary unresectable LAPC were chosen to undergo secondary resection. Tumour free resection margins could be achieved in 39.2% (R0-resection), R1-resections were seen in 41.2%, residual macroscopic tumour in 11.8% (R2) and in 7.8% resection were classified as Rx. Patients with complete resection after CRT showed a significantly increased median overall survival (OS) with 22.1 compared to 11.9 months in non-resected patients. Median OS and disease-free survival (DFS) of all patients were 12.3 and 8.1 months respectively. In most cases the first site of disease progression was systemic with hepatic (52%) and peritoneal (36%) metastases.Discussion: A high percentage of patients with locally advanced pancreatic cancer can undergo secondary resection after gemcitabine-based chemoradiation and has a relative long-term prognosis after complete resection.

Details

OriginalspracheEnglisch
Aufsatznummer28
FachzeitschriftRadiation oncology
Jahrgang7
Ausgabenummer1
PublikationsstatusVeröffentlicht - 2 März 2012
Peer-Review-StatusJa
Extern publiziertJa

Externe IDs

PubMed 22385572

Schlagworte