Adjuvant radiation therapy for pancreatic cancer: A 15-Year experience

Dobelbower, Ralph R.; Merrick, Hollis W.; Khuder, Sadik A.; Battle, J.A.; Herron, Lisa M.; Pawlicki, Todd

doi:10.1016/s0360-3016(97)00125-9

Cited by 45 publications

(30 citation statements)

References 16 publications

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“…Adjuvant EBRT and IORT have been used alone and in combination in the adjuvant setting (Table 2) [21, 32,[53][54][55][56][57][58][59][60] . The majority of studies indicate that EBRT alone or in combination with IORT has a significant survival advantage over the use of IORT alone.…”

Section: Adjuvant Radiotherapy (Chemoradiotherapy)mentioning

confidence: 99%

“…The trial will recruit 110 patients into each arm and will be completed by 2007 aiming to provide a definitive answer to the role of adjuvant regional therapy for pancreatic cancer. [54] 1997 27 14 2 7 12.5-201 7 Dobelbower et al [55] [60] 2000 22 47 1 3 4 9 81 EBRT = external beam radiotherapy; IORT = intraoperative radiotherapy; nm = nega tive resection margin; pm = positive resection margin; pdc = pancreatic ductal adenocarcinoma.…”

Section: Adjuvant Regional Therapymentioning

confidence: 99%

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Adjuvant therapy for pancreatic cancer

Neoptolemos

Kerr

1995

British Journal of Surgery

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The outlook for patients with pancreatic cancer has been grim. There have been major advances in the surgical treatment of pancreatic cancer, leading to a dramatic reduction in post-operative mortality from the development of high volume specialized centres. This stimulated the study of adjuvant and neoadjuvant t r e a t m e n t s i n p a n c r e a t i c c a n c e r i n c l u d i n g chemoradiotherapy and chemotherapy. Initial protocols have been based on the original but rather small GITSG study first reported in 1985. There have been two large European trials totalling over 600 patients (EORTC and ESPAC-1) that do not support the use of chemoradiation as adjuvant therapy. A second major finding from the ESPAC-1 trial (541 patients randomized) was some but not conclusive evidence for a survival benefit associated with chemotherapy. A third major finding from the ESPAC-1 trial was that the quality of life was not affected by the use of adjuvant treatments compared to surgery alone. The ESPAC-3 trial aims to assess the definitive use of adjuvant chemotherapy in a randomized controlled trial of 990 patients. Subject headingspancreatic neoplasms/drug therapy; pancreatic neoplasms/radiotherapy; human; review Ghaneh P, Slavin J, Sutton R, Hartley M, Neoptolemos JP.

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Section: Adjuvant Radiotherapy (Chemoradiotherapy)mentioning

confidence: 99%

“…The trial will recruit 110 patients into each arm and will be completed by 2007 aiming to provide a definitive answer to the role of adjuvant regional therapy for pancreatic cancer. [54] 1997 27 14 2 7 12.5-201 7 Dobelbower et al [55] [60] 2000 22 47 1 3 4 9 81 EBRT = external beam radiotherapy; IORT = intraoperative radiotherapy; nm = nega tive resection margin; pm = positive resection margin; pdc = pancreatic ductal adenocarcinoma.…”

Section: Adjuvant Regional Therapymentioning

confidence: 99%

Adjuvant therapy for pancreatic cancer

Neoptolemos

Kerr

1995

British Journal of Surgery

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“…Several nonrandomized prospective experiences of postoperative management with either RT alone [16, 17, 20, 22, 25, 26, 27], or RT concomitant to 5-FU, both as a bolus [16, 20, 22, 23, 24, 25, 26]and as protracted venous infusion [28], or RT concomitant to gemcitabine [29], or RT concomitant to a three-drug therapy [30]have been reported (table 3). Actuarial 2-year OS from these series ranged between 20 and 64%.…”

Section: Discussionmentioning

confidence: 99%

Final Results of a Prospective Trial of a PEFG (Cisplatin, Epirubicin, 5-Fluorouracil, Gemcitabine) Regimen Followed by Radiotherapy after Curative Surgery for Pancreatic Adenocarcinoma

Reni¹,

Passoni²,

Bonetto³

et al. 2005

Oncology

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Background: Postoperative management of patients with pancreatic adenocarcinoma (PA) is controversial. Methods: The aim of this pilot study was to assess the feasibility of postoperative combination chemotherapy followed by radiotherapy in patients aged 18–70 years with a histological diagnosis of PA, and Karnofsky performance status (KPS) ≧70. Cisplatin and epirubicin 40 mg/m² on day 1, gemcitabine 600 mg/m² on day 1 and 8, and 5-fluorouracil 200 mg/m²/day as protracted infusion (PEFG regimen) were delivered every 28 days for 4 cycles. Assuming a minimum one-year disease-free survival (DFS) of interest of 65% and a maximum of low interest of 45% (α 0.05; β 0.10), the target enrollment was 51 patients, and the strategy would be considered to deserve further analysis if more than 29 patients were DF at one-year from surgery. Results: Fifty-one patients, KPS >80: 29, median tumor size 3.5 cm, stage II/III/IVA: 2/34/13, grade 3–4: 22, positive resection margins: 26, node positive: 46, received 179 cycles of chemotherapy. Main grade 3/4 toxicity consisted of neutropenia (51%), thrombocytopenia (18%), and anemia (4%). One-year DFS was 67 ± 7%. Two-year overall survival was 53 ± 7%. Conclusion: Postoperative management of PA with this multimodality strategy was well tolerated and yielded a promising outcome.

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“…The trial will recruit 110 patients into each arm and will be completed by 2007 aiming to provide a definitive answer to the role of adjuvant regional therapy for pancreatic cancer. [53] 1993 26 45-55 20 18 Zerbi et al [21] 1994 43 12.5-20 1 9 71 7 4 7 1 2 49 10 Di Carlo et al [54] 1997 27 14 2 7 12.5-201 7 Dobelbower et al [55] 1997 [57] 1998 34 24 EBRT 13 EBRT + IOR 1 3 59 19 Klinkenbijl et al* [58] 1999 54pdc 12.6 10 60pdc 4 0 17.1 20 Mehta et al [59] 2000 52 45-54 8 IORT 32 75 38 Lee et al [60] 2000 22 47 1 3 4 9 81 EBRT = external beam radiotherapy; IORT = intraoperative radiotherapy; nm = nega tive resection margin; pm = positive resection margin; pdc = pancreatic ductal adenocarcinoma.…”

Section: Adjuvant Regional Therapymentioning

confidence: 99%