Phase II trial of primary radiation therapy and concurrent chemotherapy for patients with locally advanced pancreatic cancer

A. Magnino, M. Gatti, P. Massucco, E. Sperti, R. Faggiuolo, D. Regge, L. Capussotti, P. Gabriele, M. Aglietta

Research output: Contribution to journalArticle

Abstract

Objectives: Primary chemoradiotherapy for locally advanced pancreatic cancer (LAPC) may improve local control, curative resection rate and long-term survival. We performed a phase II study to evaluate toxicity and activity of primary radiation therapy and concurrent chemotherapy with gemcitabine (GEM) twice weekly in patients (pts) with LAPC. Methods: From 6/1999 to 6/2003, 23 LAPC pts received GEM 100 mg/m2 twice weekly in the first 15 pts and 50 mg/m2 in the last 8 pts, concurrently with radiotherapy (1.8 Gy/day for a total dose of 45 Gy). Results: The treatment was completed in 19/23 pts. Toxicities: G3-4 hematological toxicity occurred in 35 and 4% respectively; G3 nausea and vomiting and gastrointestinal toxicity in 30%. Clinical benefit was found in 10/18 pts (55%). Overall response: partial response rate 4/18 (22%); stable disease 13/18 (72%); progressive disease 1/18 (6%). Six pts underwent pancreaticoduodenectomy with extended lymphadenectomy (5/6 pts pT3, 1/6 pts microscopic cancer foci, 1/6 N+, 5/6 negative retroperitoneal margin). Median survival: 14 months for the entire group, 12 months for unresected pts, 20 months for resected pts. Conclusions: The treatment with GEM twice weekly at 50 mg/m2 associated with radiotherapy (45 Gy) is feasible and permits to obtain clinical benefit in a good percentage of pts. Objective response, median survival, and local and systemic control are similar to other studies and need further improvement.

Original languageEnglish
Pages (from-to)493-499
Number of pages7
JournalOncology
Volume68
Issue number4-6
DOIs
Publication statusPublished - Aug 2005

Keywords

  • Chemotherapy
  • Gemcitabine
  • Locally advanced
  • Pancreatic cancer
  • Radiotherapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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