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Neoadjuvant chemoradiation with Gemcitabine for locally advanced pancreatic cancer
INTRODUCTION: To evaluate efficacy and secondary resectability in patients with locally advanced pancreatic cancer (LAPC) treated with neoadjuvant chemoradiotherapy (CRT). PATIENTS AND METHODS: A total of 215 patients with locally advanced pancreatic cancer were treated with chemoradiation at a sing...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338091/ https://www.ncbi.nlm.nih.gov/pubmed/22385572 http://dx.doi.org/10.1186/1748-717X-7-28 |
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author | Habermehl, Daniel Kessel, Kerstin Welzel, Thomas Hof, Holger Abdollahi, Amir Bergmann, Frank Rieken, Stefan Weitz, Jürgen Werner, Jens Schirmacher, Peter Büchler, Markus W Debus, Jürgen Combs, Stephanie E |
author_facet | Habermehl, Daniel Kessel, Kerstin Welzel, Thomas Hof, Holger Abdollahi, Amir Bergmann, Frank Rieken, Stefan Weitz, Jürgen Werner, Jens Schirmacher, Peter Büchler, Markus W Debus, Jürgen Combs, Stephanie E |
author_sort | Habermehl, Daniel |
collection | PubMed |
description | INTRODUCTION: To evaluate efficacy and secondary resectability in patients with locally advanced pancreatic cancer (LAPC) treated with neoadjuvant chemoradiotherapy (CRT). PATIENTS AND METHODS: A total of 215 patients with locally advanced pancreatic cancer were treated with chemoradiation at a single institution. Radiotherapy was delivered with a median dose of 52.2 Gy in single fractions of 1.8 Gy. Chemotherapy was applied concomitantly as gemcitabine (GEM) at a dose of 300 mg/m(2 )weekly, followed by adjuvant cycles of full-dose GEM (1000 mg/m(2)). After neoadjuvant CRT restaging was done to evaluate secondary resectability. Overall and disease-free survival were calculated and prognostic factors were estimated. RESULTS: After CRT a total of 26% of all patients with primary unresectable LAPC were chosen to undergo secondary resection. Tumour free resection margins could be achieved in 39.2% (R0-resection), R1-resections were seen in 41.2%, residual macroscopic tumour in 11.8% (R2) and in 7.8% resection were classified as Rx. Patients with complete resection after CRT showed a significantly increased median overall survival (OS) with 22.1 compared to 11.9 months in non-resected patients. Median OS and disease-free survival (DFS) of all patients were 12.3 and 8.1 months respectively. In most cases the first site of disease progression was systemic with hepatic (52%) and peritoneal (36%) metastases. DISCUSSION: A high percentage of patients with locally advanced pancreatic cancer can undergo secondary resection after gemcitabine-based chemoradiation and has a relative long-term prognosis after complete resection. |
format | Online Article Text |
id | pubmed-3338091 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-33380912012-04-27 Neoadjuvant chemoradiation with Gemcitabine for locally advanced pancreatic cancer Habermehl, Daniel Kessel, Kerstin Welzel, Thomas Hof, Holger Abdollahi, Amir Bergmann, Frank Rieken, Stefan Weitz, Jürgen Werner, Jens Schirmacher, Peter Büchler, Markus W Debus, Jürgen Combs, Stephanie E Radiat Oncol Research INTRODUCTION: To evaluate efficacy and secondary resectability in patients with locally advanced pancreatic cancer (LAPC) treated with neoadjuvant chemoradiotherapy (CRT). PATIENTS AND METHODS: A total of 215 patients with locally advanced pancreatic cancer were treated with chemoradiation at a single institution. Radiotherapy was delivered with a median dose of 52.2 Gy in single fractions of 1.8 Gy. Chemotherapy was applied concomitantly as gemcitabine (GEM) at a dose of 300 mg/m(2 )weekly, followed by adjuvant cycles of full-dose GEM (1000 mg/m(2)). After neoadjuvant CRT restaging was done to evaluate secondary resectability. Overall and disease-free survival were calculated and prognostic factors were estimated. RESULTS: After CRT a total of 26% of all patients with primary unresectable LAPC were chosen to undergo secondary resection. Tumour free resection margins could be achieved in 39.2% (R0-resection), R1-resections were seen in 41.2%, residual macroscopic tumour in 11.8% (R2) and in 7.8% resection were classified as Rx. Patients with complete resection after CRT showed a significantly increased median overall survival (OS) with 22.1 compared to 11.9 months in non-resected patients. Median OS and disease-free survival (DFS) of all patients were 12.3 and 8.1 months respectively. In most cases the first site of disease progression was systemic with hepatic (52%) and peritoneal (36%) metastases. DISCUSSION: A high percentage of patients with locally advanced pancreatic cancer can undergo secondary resection after gemcitabine-based chemoradiation and has a relative long-term prognosis after complete resection. BioMed Central 2012-03-02 /pmc/articles/PMC3338091/ /pubmed/22385572 http://dx.doi.org/10.1186/1748-717X-7-28 Text en Copyright ©2012 Habermehl et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Habermehl, Daniel Kessel, Kerstin Welzel, Thomas Hof, Holger Abdollahi, Amir Bergmann, Frank Rieken, Stefan Weitz, Jürgen Werner, Jens Schirmacher, Peter Büchler, Markus W Debus, Jürgen Combs, Stephanie E Neoadjuvant chemoradiation with Gemcitabine for locally advanced pancreatic cancer |
title | Neoadjuvant chemoradiation with Gemcitabine for locally advanced pancreatic cancer |
title_full | Neoadjuvant chemoradiation with Gemcitabine for locally advanced pancreatic cancer |
title_fullStr | Neoadjuvant chemoradiation with Gemcitabine for locally advanced pancreatic cancer |
title_full_unstemmed | Neoadjuvant chemoradiation with Gemcitabine for locally advanced pancreatic cancer |
title_short | Neoadjuvant chemoradiation with Gemcitabine for locally advanced pancreatic cancer |
title_sort | neoadjuvant chemoradiation with gemcitabine for locally advanced pancreatic cancer |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338091/ https://www.ncbi.nlm.nih.gov/pubmed/22385572 http://dx.doi.org/10.1186/1748-717X-7-28 |
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