BACKGROUND: Effectiveness and feasibility of preoperative chemoradiation (CRT) in locally advanced adenocarcinoma of the pancreas are evaluated. MATERIAL AND METHODS: 29 eligible of 37 registered patients were treated. 3d-Conformal external radiotherapy was delivered with a 1.8-Gy single dose and a total dose of 50.4 Gy plus 5.4 Gy boost. Simultaneous chemotherapy consisted of 5-fluorouracil and mitomycin C. RESULTS: Among 27 completely treated patients, 16 (59%) underwent surgery, 6 of them being irresectable intraoperatively. Ten patients (37%) had clear resection margins at Whipple's procedure. Eleven patients were not considered for surgery (7 still irresectable at restaging, 3 distant metastases, 1 refusal of surgery). Toxicity was predominantly hematological (grade 3: 30%, grade 4: 7%); furthermore, there was nausea/vomiting (grade 3: 20%, grade 4: 0%). No patient died perioperatively. The tumor-related overall survival rate was better for resected patients than for nonresected patients (50% vs. 6%, 2-year survival, p = 0.07), median overall survival was 9 months (median follow-up, 28 months). CONCLUSIONS: Neoadjuvant CRT without significant acute toxicity produced a resectability rate of 37% (all R0), which should be confirmed by randomized phase III studies. Copyright 2000 S. Karger GmbH, Freiburg
BACKGROUND: Effectiveness and feasibility of preoperative chemoradiation (CRT) in locally advanced adenocarcinoma of the pancreas are evaluated. MATERIAL AND METHODS: 29 eligible of 37 registered patients were treated. 3d-Conformal external radiotherapy was delivered with a 1.8-Gy single dose and a total dose of 50.4 Gy plus 5.4 Gy boost. Simultaneous chemotherapy consisted of 5-fluorouracil and mitomycin C. RESULTS: Among 27 completely treated patients, 16 (59%) underwent surgery, 6 of them being irresectable intraoperatively. Ten patients (37%) had clear resection margins at Whipple's procedure. Eleven patients were not considered for surgery (7 still irresectable at restaging, 3 distant metastases, 1 refusal of surgery). Toxicity was predominantly hematological (grade 3: 30%, grade 4: 7%); furthermore, there was nausea/vomiting (grade 3: 20%, grade 4: 0%). No patient died perioperatively. The tumor-related overall survival rate was better for resected patients than for nonresected patients (50% vs. 6%, 2-year survival, p = 0.07), median overall survival was 9 months (median follow-up, 28 months). CONCLUSIONS: Neoadjuvant CRT without significant acute toxicity produced a resectability rate of 37% (all R0), which should be confirmed by randomized phase III studies. Copyright 2000 S. Karger GmbH, Freiburg
Authors: Maria Wolf; Franz Zehentmayr; Maximilian Niyazi; Ute Ganswindt; Wolfgang Haimerl; Michael Schmidt; Dieter Hölzel; Claus Belka Journal: Strahlenther Onkol Date: 2010-06-24 Impact factor: 3.621
Authors: Dominik Tinkl; Gerhard G Grabenbauer; Henriette Golcher; Thomas Meyer; Thomas Papadopoulos; Werner Hohenberger; Rolf Sauer; Thomas B Brunner Journal: Strahlenther Onkol Date: 2009-09-12 Impact factor: 3.621