Results of a phase II trial of epirubicin and cisplatin (EP) before and after irradiation and 5-fluorouracil in locally advanced pancreatic cancer: An EORTC GITCCG study

Wagener, D. J. Th.; Hoogenraad, W.J.; Rougier, P; Lusinchi, A.; Taal, Babs G.; Veenhof, C. H. N.; Graeff, Alexander de; Conroy, Thierry; Curran, Desmond; Sahmoud, Tarek; Wils, J.

doi:10.1016/0959-8049(96)00070-6

Cited by 22 publications

(6 citation statements)

References 13 publications

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“…Wagener et al 31 treated 53 patients with three cycles of epirubicin and CDDP, followed by 5-FU-based EBRT (40 Gy). Wagener et al 31 treated 53 patients with three cycles of epirubicin and CDDP, followed by 5-FU-based EBRT (40 Gy).…”

Section: Results In Patients With Unresectable Pcmentioning

confidence: 99%

Non-surgical treatments of pancreatic cancer

Okada¹

1999

International Journal of Clinical Oncology

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Although pancreatic cancer (PC) continues to be a formidable disease, numerous treatment strategies are evolving and it is hoped that these will result in improved patient survival. Only surgical resection offers the opportunity for cure, but the prognosis of resected patients remains unfavorable because of postoperative recurrence. Accordingly, to improve the survival of PC patients, it is essential to develop effective non-surgical treatments for this disease. Radiotherapy (RT) alone does not have a significant clinical impact in PC, but when combined with chemotherapy (CHT), it provides a survival benefit in both locally unresectable and adjuvant settings of PC. However, to establish optimal methods of combining RT with CHT, newer approaches, such as specialized RT techniques and new CHT agents, are actively being pursued. CHT for PC has only limited value in clinical practice, because of the lack of any agent with a truly high level of activity. The identification of more effective new agents is therefore a high priority, and the enrollment of PC patients with metastatic disease into well designed clinical trials is essential. The novel nucleoside analog, gemcitabine, appears to have the potential to produce better results than those achieved over the last 35 years with 5-fluorouracil (5-FU). Moreover, increased understanding of the biology of PC should facilitate the development of entirely novel treatment options. We must continue to actively search for more effective nonsurgical treatments for PC.

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Section: Results In Patients With Unresectable Pcmentioning

confidence: 99%

Non-surgical treatments of pancreatic cancer

Okada¹

1999

International Journal of Clinical Oncology

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“…To intensify the treatment efficacy, various anticancer agents and radiation schedules are being investigated in clinical trials of chemoradiotherapy (Roldan et al, 1988;Seydel et al, 1990;Wagener et al, 1996;Thomas et al, 1997;Prott et al, 1997;Okusaka et al, 2001). However, marked improvement in their survival has not been observed.…”

Section: Discussionmentioning

confidence: 99%

Phase II study of radiotherapy combined with gemcitabine for locally advanced pancreatic cancer

Okusaka¹,

Ito

Ueno³

et al. 2004

Br J Cancer

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Gemcitabine has been reported to be a potent radiosensitiser in human pancreatic cell lines. This study was conducted to evaluate the efficacy and toxicity of radiotherapy combined with gemcitabine for locally advanced pancreatic cancer. In all, 42 patients with pancreatic cancer that was unresectable but confined to the pancreatic region were treated with external-beam radiation (50.4 Gy in 28 fractions over 5.5 weeks) and weekly gemcitabine (250 mg m À2 , 30-min infusion). Maintenance gemcitabine (1000 mg m À2 weekly Â 3 every 4 weeks) was initiated 1 month after the completion of the chemoradiotherapy and continued until disease progression or unacceptable toxicity. Of the 42 patients, 38 (90%) completed the scheduled course of chemoradiotherapy. The major toxicity was leucopenia and anorexia. There was one death attributed to duodenal bleeding and sepsis. The median survival time was 9.5 months and the 1-year survival rate was 28%. The median progression-free survival time was 4.4 months. In 35 patients with documented disease progression at the time of analysis, 34 (97%) showed distant metastasis as the cause of the initial disease progression. The chemoradiotherapy used in this study has a moderate activity against locally advanced pancreatic cancer and an acceptable toxicity profile. Future investigations for treatment with more systemic effects are warranted.

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“…Pancreatic carcinoma has very unfavorable treatment results compared with other gastrointestinal carcinomas, with the surgical resection rate being 14.2%2, 17 Even in the resected cases, the 1‐, 3‐, and 5‐year survival rates are as low as 49.8%, 16.8%, and 9.6%, respectively 17. Systemic adjuvant chemotherapy for pancreatic carcinoma has not increased the 5‐year survival rate,18, 19 and the addition of adjuvant chemotherapy plus radiation has not provided any significant advantage in survival 20, 21. The cause of death in patients with advanced pancreatic carcinoma is primarily the local progression of cancer and distant metastases 3, 7, 13.…”

Section: Discussionmentioning

confidence: 99%

“…Some reports therefore have described that only symptomatic support should be performed for Stage IV advanced pancreatic carcinoma 7, 24. But, previous studies have shown that palliative chemotherapy improves overall survival compared with no treatment without impairing quality of life 1, 6, 7, 10, 11, 20–22, 24–28. Various efforts to improve chemotherapy for advanced pancreatic carcinoma have been made in terms of the kind of anticancer agents, dosage, dosing period, and route of administration.…”

Section: Discussionmentioning

confidence: 99%

A novel arterial infusion chemotherapy for the treatment of patients with advanced pancreatic carcinoma after vascular supply distribution via superselective embolization

Homma

Doi

Mezawa

et al. 2000

Cancer

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BACKGROUND Patients with American Joint Committee on Cancer Stage IV advanced pancreatic carcinoma have been treated by systemic chemotherapy, intraarterial chemotherapy, radiation therapy, and multidisciplinary treatment using a combination of these. However, the outcome has not always been satisfactory. In the current study the authors describe the method and results of a new chemotherapy for advanced pancreatic carcinoma. METHODS To restrict the blood flow into the pancreas (mainly to the great pancreatic artery and the caudal pancreatic artery), the peripancreatic blood vessels were embolized superselectively with microcoils. In 31 patients with advanced pancreatic carcinoma, the catheter tip for the arterial infusion chemotherapy was placed in the splenic artery just proximal to the branching of the great pancreatic artery when the treatment was given for primary tumors, and in the common hepatic artery when the treatment was given for a metastatic liver lesion. The other end of the catheter was connected to an implanted injection port embedded in the femoral region, and 5‐fluorouracil and cisplatin were administered by continuous arterial infusion. RESULTS Of the 31 patients with advanced pancreatic carcinoma, 23 (74%) underwent hemodynamic change and arterial infusion chemotherapy, with a response rate of 73.9% (complete response rate of 8.7% and a partial response rate of65.2%) and a mean survival period of 18.26 ± 10.06 months. The 1‐year, 2‐year, and 3‐year survival rates were 90.9%, 42.8%, and 18.3%, respectively, with a mean survival period of 19.0 months. Of these 23 patients, the 16 patients with liver metastases had a response rate of 68.8% and a mean survival period of 16.25 ± 8.35 months, whereas the 7 patients without liver metastases had a response rate of 87.5% and a mean survival period of 22.86 ± 12.69 months. CONCLUSIONS In patients with Stage IV advanced pancreatic carcinoma, arterial infusion chemotherapy after hemodynamic change was found to be effective against both primary tumors and metastatic liver lesions. The authors believe that the treatment presented in the current study should be attempted, even in patients with advanced pancreatic carcinoma, as long as the blood vessels for vascular supply distribution exist. Cancer 2000;89:303–13. © 2000 American Cancer Society.

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Results of a phase II trial of epirubicin and cisplatin (EP) before and after irradiation and 5-fluorouracil in locally advanced pancreatic cancer: An EORTC GITCCG study

Cited by 22 publications

References 13 publications

Non-surgical treatments of pancreatic cancer

Non-surgical treatments of pancreatic cancer

Phase II study of radiotherapy combined with gemcitabine for locally advanced pancreatic cancer

A novel arterial infusion chemotherapy for the treatment of patients with advanced pancreatic carcinoma after vascular supply distribution via superselective embolization

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