Adjuvant gemcitabine and concurrent continuous radiation (45 Gy) for resected pancreatic head carcinoma: A multicenter Belgian phase II study

Demols, A.; Peeters, Marc; Polus, Marc; Honoré, Pierre; Boterberg, Tom; Closon, Marie-Thérèse; Houtte, Paul Van; Closset, Jean; Laethem, Jean‐Luc Van

doi:10.1016/j.ijrobp.2005.01.043

Cited by 24 publications

(17 citation statements)

References 13 publications

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“…The number of clinical studies on the application of the combination of radiation therapy with Gem is very scarce. The total duration of the survival of patients with resectable pancreatic cancer treated with Gem (300 mg/m 2 ) together with radiation therapy (total focal dose -45 Gy) during phase II multicenter study was 19 months (14). These results are better than those obtained during our study (MS -12 months), and longer survival period might have been influenced by differences in the treatment techniques.…”

Section: The Analysis Of the Survival Resultscontrasting

confidence: 58%

The effect of combined treatment methods on survival and toxicity in patients with pancreatic cancer

Brasiūnienė¹,

Juozaitytė²

2007

Medicina

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In Lithuania, there were 476 new pancreatic cancer cases in 2005. Based on international scientific literature and the results of our retrospective studies, a prospective study has been designed. The aim of study was a prospective evaluation of the impact of two concomitant chemoradiation methods on the survival and the time to disease progression in patients diagnosed with resectable and unresectable pancreatic cancer and prospective evaluation of the safety of two concomitant chemoradiation methods for the treatment of resectable and unresectable pancreatic cancer. Material and methods. During the period of 2000–2005 at the Clinic of Oncology, Kaunas University of Medicine Hospital, we performed a prospective randomized study to analyze two concomitant chemoradiation treatment methods. The patients were stratified according to the resectability of the tumor: with resectable tumor (stage I–IVA) and with unresectable tumor (stage III–IVA). Treatment for each group of patients was selected randomly choosing concomitant chemoradiation treatment: radiation therapy and 5-fluorouracil or radiation therapy and gemcitabine. Criteria of the efficacy of the treatment methods were median survival, time to disease progression, and treatment safety (qualitative and quantitative analysis). Results and conclusions. The treatment methods – radiotherapy and 5-fluorouracil or radiotherapy and gemcitabine – were equally effective when assessing the survival and time to disease progression in patients diagnosed with pancreatic cancer. Treatment of patients diagnosed with pancreatic cancer with radiotherapy and 5-fluorouracil was a safer approach than treatment with radiotherapy and gemcitabine, which induced more severe toxic adverse effects.

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Section: The Analysis Of the Survival Resultscontrasting

confidence: 58%

The effect of combined treatment methods on survival and toxicity in patients with pancreatic cancer

Brasiūnienė¹,

Juozaitytė²

2007

Medicina

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“…With a median follow-up period of 19 months, the local failure rate was 36.8 %. 20 This study, which was preceded by another phase II trial investigating the feasibility of gemcitabine-based split-course RT, 21 showed that administering continuous RT did not increase acute toxicity (grade 3-4 hematological toxicity, 33 vs. 36 % of split course study).…”

Section: Discussionmentioning

confidence: 95%

Long-term Analysis of Gemcitabine-based Chemoradiation after Surgical Resection for Pancreatic Adenocarcinoma

et al. 2012

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“…We previously conducted two phase II multicentric studies evaluating (15,16) adjuvant chemoradiotherapy with gemcitabine for completely resected pancreatic adenocarcinoma. Both regimens shared similar designs, were highly feasible, and produced limited toxicity.…”

Section: Discussionmentioning

confidence: 99%

“…Patients from two Belgian multicentric phase II studies evaluating the feasibility of adjuvant gemcitabine-based combined regimen in resected pancreatic cancer patients between 2000 and 2003 were studied (15,16). Both studies were approved by the ethics committees of each participating center.…”

Section: Methodsmentioning

confidence: 99%

Human Equilibrative Nucleoside Transporter 1 and Human Concentrative Nucleoside Transporter 3 Predict Survival after Adjuvant Gemcitabine Therapy in Resected Pancreatic Adenocarcinoma

Maréchal¹,

Mackey²,

Lai

et al. 2009

Clinical Cancer Research

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199

159

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Purpose: Gemcitabine is a promising adjuvant treatment for patients with resected pancreatic adenocarcinoma and its use in combination with radiotherapy is under exploration. Human equilibrative nucleoside transporter 1(hENT1) and human concentrative nucleoside transporter (hCNT) 1and 3 are the major transporters responsible for 2 ¶,2 ¶-difluoro-2-deoxycytidine (gemcitabine) uptake into cells. The aim of this study was to determine patients' outcome according to the expression of hENT1 and hCNT3 in tumoral cells after postoperative gemcitabine-based chemoradiation regimen. Experimental Design: We studied tumor blocks from 45 pancreatic adenocarcinoma patients treated with gemcitabine-based chemoradiation after curative resection and assessed hENT1and hCNT3 expression using immunohistochemistry. Results: When adjusted for the effects of lymph node ratio and tumor diameter, patients with high hENT1 expression had significantly longer disease-free survival and overall survival (OS) than patients with low expression, whereas high hCNT3 expression was only associated with longer OS. In a combined analysis, patients with two favorable prognostic factors (hENT1 high / hCNT3 high expression) had a longer survival (median OS, 94.8 months) than those having one (median OS, 18.7 months) or no (median OS, 12.2 months) favorable prognostic factor. Conclusions: Pancreatic adenocarcinoma patients with a high expression of hENT1and hCNT3 immunostaining have a significantly longer survival after adjuvant gemcitabine-based chemoradiation. These biomarkers deserve prospective evaluation in patients receiving gemcitabinebased adjuvant therapy.Pancreatic head adenocarcinoma has a very poor prognosis.Even after curative surgery, which concerns only 10% to 15% of patients at the time of the diagnosis, 5-year survival is only 10% to 20% and median survival is 20 to 24 months (1, 2). This poor survival rate is attributed to a high rate of local recurrence and development of distant metastases even after complete resection of the tumor (R0 surgery). Several multimodal adjuvant and neoadjuvant therapies have been developed to reduce both local and systemic recurrence of the disease and improve survival. Nevertheless, the value of such adjuvant radiotherapy and/or chemotherapy regimens remains questionable because several trials have failed to draw any firm conclusions. Most of these adjuvant treatments were based on the combination of radiation and 5-fluorouracil (2 -5).Gemcitabine is a 2 ¶,2 ¶-difluoro-2-deoxycytidine analogue that inhibits DNA replication and repair. Gemcitabine monotherapy has clinically important activity in advanced and metastatic pancreatic adenocarcinoma and for which it is now the standard of care (6). In the adjuvant setting, it was enhanced disease-free survival (DFS) and survival compared with surgery alone (7, 8) and significantly increased DFS, but not overall survival (OS), when added to 5-fluorouracil-based chemoradiotherapy in a recent RTOG trial (9).As gemcitabine possesses radiosensitizing prope...

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Adjuvant gemcitabine and concurrent continuous radiation (45 Gy) for resected pancreatic head carcinoma: A multicenter Belgian phase II study

Cited by 24 publications

References 13 publications

The effect of combined treatment methods on survival and toxicity in patients with pancreatic cancer

The effect of combined treatment methods on survival and toxicity in patients with pancreatic cancer

Long-term Analysis of Gemcitabine-based Chemoradiation after Surgical Resection for Pancreatic Adenocarcinoma

Human Equilibrative Nucleoside Transporter 1 and Human Concentrative Nucleoside Transporter 3 Predict Survival after Adjuvant Gemcitabine Therapy in Resected Pancreatic Adenocarcinoma

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