Effect of preoperative chemoradiotherapy on surgical margin status of resected adenocarcinoma of the head of the pancreas

Combined 90Yttrium‐DOTA‐labeled PAM4 antibody radioimmunotherapy and gemcitabine radiosensitization for the treatment of a human pancreatic cancer xenograft

“…AUC analyses were supported by statistical comparisons of survival data; in this case, survival was defined as the time for a tumor to reach 5 cm. 3 At the termination of the study, some of the animals had not yet experienced the endpoint and their observations were considered as censored. The Mantel-Haenszel, log-rank test was then used for comparison of treatment arms.…”

“…[42][43][44] Although few patients are deemed to have resectable disease, recent studies have suggested that these patients may also benefit from a program of preoperative chemoradiation. [3][4][5][6][7][8][9] Those patients given preoperative chemoradiation had significantly higher numbers of disease-free margins and fewer numbers of involved lymph nodes at surgery than their counterparts treated with "curative resection" alone. Overall, the use of chemoradiation procedures has provided a modest increase in median survival time.…”

“…74 Moreover, a preponderance of clinical data show the combination to be well tolerated. [3][4][5][6][7][8][9]11,12 Since we were administering 90 Y-DOTA-cPAM4 concurrently with gemcitabine, toxicity to the intestine was a distinct possibility. However, 90 Y-PAM4 is cleared rapidly from the blood (t 1/2 ϭ28 hr) and our previous biodistribution data show that very little radiation is absorbed by the small intestine (135 cGy at 100 Ci injected dose), and therefore should not be toxic in these mice.…”

“…It was established as a solid tumor by injecting 10 7 cells subcutaneously into the right flank of 5-week-old, female athymic nu/nu mice (Taconic, Germantown, NY). Once tumors had grown to approximately 1 cm, 3 they were propagated serially by subcutaneous injection of 0.2 ml of a 20% (w/v) tumor suspension prepared by mincing the tumors in 0.9% saline with subsequent passage through a 40-mesh wire screen. CaPan1 cells produced moderate-to well-differentiated tumors.…”

“…Gemcitabine may be useful in this regard since it is a potent radiosensitizer. 2 External beam radiotherapy combined with gemcitabine chemotherapy has been studied in patients with both resectable [3][4][5][6][7][8][9] and nonresectable tumors, 10 -12 with minimal toxicity. Although palliation of disease symptoms has been beneficial, only a moderate increase in median survival has been observed.…”