期刊
ONCOLOGY
卷 68, 期 4-6, 页码 493-499出版社
KARGER
DOI: 10.1159/000086993
关键词
pancreatic cancer; radiotherapy; chemotherapy; gemcitabine; locally advanced
类别
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/m(2) 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/m(2) 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. Copyright (C) 2005 S. Karger AG, Basel.
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