Treatment of unresectable pancreatic carcinoma using irradiation with concurrent intravenous 5-FU infusion therapy.

Ten patients with unresectable carcinoma of the pancreas who had only bypass surgery to relieve biliary obstruction were treated with radiation therapy to the pancreas and liver with concurrent 5-fluorouracil (5-FU) intravenous infusion therapy. Treatment regimen was three cycles of chemoradiotherapy with a two week rest period between cycles. 5-FU (1,000 mg/m2 per day) was administered by continuous infusion for the first five days of each cycle. In the first cycle radiotherapy was given to the pancreas to 2,000 cGy/10 fractions using 6 to 10 mV x-rays. In the second cycle 2,400 cGy/160 rads/fraction radiation was delivered to the pancreas and whole liver. In the third cycle, 1,600 cGy/160 rads/fraction to a total dose of 6,000 rads, was administered to the pancreatic tumor. All ten patients completed the treatments without interruption. No major side effects were noticed during the course of treatment. Survival ranged from 9 to 16 months and median survival was 11 months. Symptomatic relief was obtained in all 10 patients. One patient who lived for 16 months developed duodenal stenosis and underwent gastrojejunostomy.