Phase II Trial of Primary Radiation Therapy and Concurrent Chemotherapy for Patients with Locally Advanced Pancreatic Cancer
2005; Karger Publishers; Volume: 68; Issue: 4-6 Linguagem: Inglês
10.1159/000086993
ISSN1423-0232
AutoresA. Magnino, Marco Gatti, Paolo Massucco, Elisa Sperti, R. Faggiuolo, Daniele Regge, Lorenzo Capussotti, P. Gabriele, Massimo Aglietta,
Tópico(s)Cancer Genomics and Diagnostics
Resumo<i>Objectives:</i> 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. <i>Methods:</i> From 6/1999 to 6/2003, 23 LAPC pts received GEM 100 mg/m<sup>2</sup> twice weekly in the first 15 pts and 50 mg/m<sup>2</sup> in the last 8 pts, concurrently with radiotherapy (1.8 Gy/day for a total dose of 45 Gy). <i>Results:</i> 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. <i>Conclusions:</i> The treatment with GEM twice weekly at 50 mg/m<sup>2</sup> 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.
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