Induction gemcitabine and oxaliplatin therapy followed by a twice-weekly infusion of gemcitabine and concurrent external-beam radiation for neoadjuvant treatment of locally advanced pancreatic cancer: A single institutional experience

Francesco Leone, Marco Gatti, Paolo Massucco, Federica Colombi, Elisa Sperti, Delia Campanella, Daniele Regge, Pietro Gabriele, Lorenzo Capussotti, Massimo Aglietta

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Background: Chemoradiotherapy (CRT) may render curative resection feasible in patients with locally advanced pancreatic carcinoma (LAPC). The authors previously demonstrated the achievement of significant disease control and a median survival of 14 months by CRT in patients with LAPC. In this study, they evaluated the use of induction chemotherapy followed by a CRT neoadjuvant protocol. Methods: Patients first received induction gemcitabine and oxaliplatin (GEMOX) (gemcitabine 1000 mg/m2, oxaliplatin 100 mg/m2). Patients without disease progression then received gemcitabine twice weekly (50 mg/m2 daily) concurrent with radiotherapy (50.4 grays) and were re-evaluated for resectability. Results: Thirty-nine patients (15 with borderline resectable disease and 24 with unresectable disease) entered the study. The treatment was well tolerated. Disease control was obtained in 29 of 39 patients. Two patients progressed after GEMOX, and 7 progressed after CRT. After a median follow-up of 13 months, the median progression-free survival (PFS) was 10.2 months. The median PFS of patients with borderline resectable and unresectable disease was 16.6 and 9.1 months, respectively (P =.056). For the whole group, the median overall survival (OS) was 16.7 months (27.8 months for patients with borderline resectable disease, 13.3 for patients with unresectable disease; P =.045). Eleven patients (9 with borderline resectable disease and 2 with unresectable disease at diagnosis) underwent successful resection. Patients who underwent resection had a significantly longer median PFS compared with nonresected patients (19.7 months vs 7.6 months, respectively). The median OS among resected and nonresected patients was 31.5 months and 12.3 months, respectively (P

Original languageEnglish
Pages (from-to)277-284
Number of pages8
JournalCancer
Volume119
Issue number2
DOIs
Publication statusPublished - Jan 15 2013

Fingerprint

oxaliplatin
gemcitabine
Neoadjuvant Therapy
Pancreatic Neoplasms
Radiation
Chemoradiotherapy
Therapeutics
Disease-Free Survival
Survival

Keywords

  • chemoradiotherapy
  • combined modality therapy
  • locally advanced
  • neoadjuvant treatment
  • pancreatic neoplasm

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

@article{635866a1689545ada4eaee07bc0ace8a,
title = "Induction gemcitabine and oxaliplatin therapy followed by a twice-weekly infusion of gemcitabine and concurrent external-beam radiation for neoadjuvant treatment of locally advanced pancreatic cancer: A single institutional experience",
abstract = "Background: Chemoradiotherapy (CRT) may render curative resection feasible in patients with locally advanced pancreatic carcinoma (LAPC). The authors previously demonstrated the achievement of significant disease control and a median survival of 14 months by CRT in patients with LAPC. In this study, they evaluated the use of induction chemotherapy followed by a CRT neoadjuvant protocol. Methods: Patients first received induction gemcitabine and oxaliplatin (GEMOX) (gemcitabine 1000 mg/m2, oxaliplatin 100 mg/m2). Patients without disease progression then received gemcitabine twice weekly (50 mg/m2 daily) concurrent with radiotherapy (50.4 grays) and were re-evaluated for resectability. Results: Thirty-nine patients (15 with borderline resectable disease and 24 with unresectable disease) entered the study. The treatment was well tolerated. Disease control was obtained in 29 of 39 patients. Two patients progressed after GEMOX, and 7 progressed after CRT. After a median follow-up of 13 months, the median progression-free survival (PFS) was 10.2 months. The median PFS of patients with borderline resectable and unresectable disease was 16.6 and 9.1 months, respectively (P =.056). For the whole group, the median overall survival (OS) was 16.7 months (27.8 months for patients with borderline resectable disease, 13.3 for patients with unresectable disease; P =.045). Eleven patients (9 with borderline resectable disease and 2 with unresectable disease at diagnosis) underwent successful resection. Patients who underwent resection had a significantly longer median PFS compared with nonresected patients (19.7 months vs 7.6 months, respectively). The median OS among resected and nonresected patients was 31.5 months and 12.3 months, respectively (P",
keywords = "chemoradiotherapy, combined modality therapy, locally advanced, neoadjuvant treatment, pancreatic neoplasm",
author = "Francesco Leone and Marco Gatti and Paolo Massucco and Federica Colombi and Elisa Sperti and Delia Campanella and Daniele Regge and Pietro Gabriele and Lorenzo Capussotti and Massimo Aglietta",
year = "2013",
month = "1",
day = "15",
doi = "10.1002/cncr.27736",
language = "English",
volume = "119",
pages = "277--284",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "2",

}

TY - JOUR

T1 - Induction gemcitabine and oxaliplatin therapy followed by a twice-weekly infusion of gemcitabine and concurrent external-beam radiation for neoadjuvant treatment of locally advanced pancreatic cancer

T2 - A single institutional experience

AU - Leone, Francesco

AU - Gatti, Marco

AU - Massucco, Paolo

AU - Colombi, Federica

AU - Sperti, Elisa

AU - Campanella, Delia

AU - Regge, Daniele

AU - Gabriele, Pietro

AU - Capussotti, Lorenzo

AU - Aglietta, Massimo

PY - 2013/1/15

Y1 - 2013/1/15

N2 - Background: Chemoradiotherapy (CRT) may render curative resection feasible in patients with locally advanced pancreatic carcinoma (LAPC). The authors previously demonstrated the achievement of significant disease control and a median survival of 14 months by CRT in patients with LAPC. In this study, they evaluated the use of induction chemotherapy followed by a CRT neoadjuvant protocol. Methods: Patients first received induction gemcitabine and oxaliplatin (GEMOX) (gemcitabine 1000 mg/m2, oxaliplatin 100 mg/m2). Patients without disease progression then received gemcitabine twice weekly (50 mg/m2 daily) concurrent with radiotherapy (50.4 grays) and were re-evaluated for resectability. Results: Thirty-nine patients (15 with borderline resectable disease and 24 with unresectable disease) entered the study. The treatment was well tolerated. Disease control was obtained in 29 of 39 patients. Two patients progressed after GEMOX, and 7 progressed after CRT. After a median follow-up of 13 months, the median progression-free survival (PFS) was 10.2 months. The median PFS of patients with borderline resectable and unresectable disease was 16.6 and 9.1 months, respectively (P =.056). For the whole group, the median overall survival (OS) was 16.7 months (27.8 months for patients with borderline resectable disease, 13.3 for patients with unresectable disease; P =.045). Eleven patients (9 with borderline resectable disease and 2 with unresectable disease at diagnosis) underwent successful resection. Patients who underwent resection had a significantly longer median PFS compared with nonresected patients (19.7 months vs 7.6 months, respectively). The median OS among resected and nonresected patients was 31.5 months and 12.3 months, respectively (P

AB - Background: Chemoradiotherapy (CRT) may render curative resection feasible in patients with locally advanced pancreatic carcinoma (LAPC). The authors previously demonstrated the achievement of significant disease control and a median survival of 14 months by CRT in patients with LAPC. In this study, they evaluated the use of induction chemotherapy followed by a CRT neoadjuvant protocol. Methods: Patients first received induction gemcitabine and oxaliplatin (GEMOX) (gemcitabine 1000 mg/m2, oxaliplatin 100 mg/m2). Patients without disease progression then received gemcitabine twice weekly (50 mg/m2 daily) concurrent with radiotherapy (50.4 grays) and were re-evaluated for resectability. Results: Thirty-nine patients (15 with borderline resectable disease and 24 with unresectable disease) entered the study. The treatment was well tolerated. Disease control was obtained in 29 of 39 patients. Two patients progressed after GEMOX, and 7 progressed after CRT. After a median follow-up of 13 months, the median progression-free survival (PFS) was 10.2 months. The median PFS of patients with borderline resectable and unresectable disease was 16.6 and 9.1 months, respectively (P =.056). For the whole group, the median overall survival (OS) was 16.7 months (27.8 months for patients with borderline resectable disease, 13.3 for patients with unresectable disease; P =.045). Eleven patients (9 with borderline resectable disease and 2 with unresectable disease at diagnosis) underwent successful resection. Patients who underwent resection had a significantly longer median PFS compared with nonresected patients (19.7 months vs 7.6 months, respectively). The median OS among resected and nonresected patients was 31.5 months and 12.3 months, respectively (P

KW - chemoradiotherapy

KW - combined modality therapy

KW - locally advanced

KW - neoadjuvant treatment

KW - pancreatic neoplasm

UR - http://www.scopus.com/inward/record.url?scp=84872074351&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84872074351&partnerID=8YFLogxK

U2 - 10.1002/cncr.27736

DO - 10.1002/cncr.27736

M3 - Article

C2 - 22778019

AN - SCOPUS:84872074351

VL - 119

SP - 277

EP - 284

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 2

ER -