PURPOSE: To assess the safety and efficacy of a new neoadjuvant chemoradiation (CRT) docetaxel-based regimen in patients with resectable adenocarcinoma of the pancreatic head or body. PATIENTS AND METHODS: 34 patients with histologically-confirmed resectable pancreatic adenocarcinoma were included in this prospective two-center phase II study. Radiotherapy was delivered at the dose of 45 Gy in 25 fractions of 1.8 Gy per fractions, 5 days/week, over 5 weeks. Docetaxel was administered as a 1-h intravenous (IV) infusion repeated every week during 5 weeks. The dose was 30 mg/m(2)/week. All patients were restaged after completion of CRT. RESULTS: Tumor progression was documented in 11 patients (32%), stable disease was documented in 20 patients (59%), and partial remission was documented in 3 patients (9%). 23 patients still with local disease at restaging underwent explorative laparotomy. Of this, 17 patients (50%) had a curative pancreaticoduodenectomy with lymphadenectomy. Morbidity and mortality rates were 29% and 0%, respectively. Three patients (17%) had complete histological responses and 5 patients had minimal residual disease. All resected patients (n = 17) underwent R0 resection. The median and five-year survival times for the resected patients were 32 months and 41%, respectively. Among the resected patients, ten (59%) died as a result of recurrent pancreatic cancer without local tumor bed recurrence. CONCLUSIONS: Neoadjuvant docetaxel-based chemoradiation is well-tolerated. Resected patients had a prolonged survival time. Further studies are needed to confirm our findings and determine the role of such a neoadjuvant approach.
PURPOSE: To assess the safety and efficacy of a new neoadjuvant chemoradiation (CRT) docetaxel-based regimen in patients with resectable adenocarcinoma of the pancreatic head or body. PATIENTS AND METHODS: 34 patients with histologically-confirmed resectable pancreatic adenocarcinoma were included in this prospective two-center phase II study. Radiotherapy was delivered at the dose of 45 Gy in 25 fractions of 1.8 Gy per fractions, 5 days/week, over 5 weeks. Docetaxel was administered as a 1-h intravenous (IV) infusion repeated every week during 5 weeks. The dose was 30 mg/m(2)/week. All patients were restaged after completion of CRT. RESULTS:Tumor progression was documented in 11 patients (32%), stable disease was documented in 20 patients (59%), and partial remission was documented in 3 patients (9%). 23 patients still with local disease at restaging underwent explorative laparotomy. Of this, 17 patients (50%) had a curative pancreaticoduodenectomy with lymphadenectomy. Morbidity and mortality rates were 29% and 0%, respectively. Three patients (17%) had complete histological responses and 5 patients had minimal residual disease. All resected patients (n = 17) underwent R0 resection. The median and five-year survival times for the resected patients were 32 months and 41%, respectively. Among the resected patients, ten (59%) died as a result of recurrent pancreatic cancer without local tumor bed recurrence. CONCLUSIONS: Neoadjuvant docetaxel-based chemoradiation is well-tolerated. Resected patients had a prolonged survival time. Further studies are needed to confirm our findings and determine the role of such a neoadjuvant approach.
Authors: Lauren E Colbert; William A Hall; Dana Nickleach; Jeffrey Switchenko; David A Kooby; Yuan Liu; Theresa Gillespie; Joseph Lipscomb; John Kauh; Jerome C Landry Journal: Cancer Date: 2014-01-03 Impact factor: 6.860
Authors: Jordan M Cloyd; Matthew H G Katz; Laura Prakash; Gauri R Varadhachary; Robert A Wolff; Rachna T Shroff; Milind Javle; David Fogelman; Michael Overman; Christopher H Crane; Eugene J Koay; Prajnan Das; Sunil Krishnan; Bruce D Minsky; Jeffrey H Lee; Manoop S Bhutani; Brian Weston; William Ross; Priya Bhosale; Eric P Tamm; Huamin Wang; Anirban Maitra; Michael P Kim; Thomas A Aloia; Jean-Nicholas Vauthey; Jason B Fleming; James L Abbruzzese; Peter W T Pisters; Douglas B Evans; Jeffrey E Lee Journal: J Gastrointest Surg Date: 2016-10-24 Impact factor: 3.452
Authors: Daniel J Renouf; Patricia A Tang; Pierre Major; Monika K Krzyzanowska; Bindi Dhesy-Thind; John R Goffin; David Hedley; Lisa Wang; L Doyle; Malcolm J Moore Journal: Invest New Drugs Date: 2011-04-28 Impact factor: 3.850
Authors: Francesco D'Angelo; Laura Antolino; Alessio Farcomeni; Dario Sirimarco; Andrea Kazemi Nava; Martina De Siena; Niccolò Petrucciani; Giuseppe Nigri; Stefano Valabrega; Paolo Aurello; Giovanni Ramacciato Journal: Med Oncol Date: 2017-04-08 Impact factor: 3.064