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. 2012 Dec;3(4):326-34.
doi: 10.3978/j.issn.2078-6891.2012.029.

Treatment of locally advanced unresectable pancreatic cancer: a 10-year experience

Nadia K Malik  1 , Kilian Salerno May, Rameela Chandrasekhar, Wen Wee, Leayn Flaherty, Renuka Iyer, John Gibbs, Boris Kuvshinoff, Gregory Wilding, Graham Warren, Gary Y Yang
Affiliations

Treatment of locally advanced unresectable pancreatic cancer: a 10-year experience

Nadia K Malik et al. J Gastrointest Oncol. 2012 Dec.

Abstract

Purpose: We retrospectively analyzed the results of patients with locally advanced unresectable pancreatic cancer (LAPC) treated with either chemoradiation (CRT) or chemotherapy alone over the past decade.

Methods and materials: Between December 1998 and October 2009, 116 patients with LAPC were treated at our institution. Eighty-four patients received concurrent chemoradiation [RT (+) group], primarily 5-flourouracil based (70%). Thirty-two patients received chemotherapy alone [RT (-) group], the majority gemcitabine based (78%). Progression-free survival (PFS) and overall survival (OS) were calculated from date of diagnosis to date of first recurrence and to date of death or last follow-up, respectively. Univariate statistical analysis was used to determine significant prognostic factors for overall survival.

Results: Median patient age was 67 years. Sixty patients were female (52%). Median follow-up was 11 months (range, 1.6-59.4 months). The RT (+) group received a median radiation dose of 50.4 Gy, was more likely to present with ECOG 0-1 performance status, and experienced less grade 3-4 toxicity. PFS was 10.9 versus 9.1 months (P=0.748) and median survival was 12.5 versus 9.1 months (P=0.998) for the RT (+) and RT (-) groups respectively (P=0.748). On univariate analysis, patients who experienced grade 3-4 toxicity had worse overall survival than those who did not (P=0.02).

Conclusions: Optimal management for LAPC continues to evolve. Patients who developed treatment-related grade 3-4 toxicity have a poorer prognosis. Survival rates were not statistically significant between chemotherapy and chemoradiotherapy groups.

Keywords: Pancreatic cancer; chemoradiation; locally advanced; survival; unresectable.

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Figures

Figure 1
Figure 1
Progression free survival (months)
Figure 2
Figure 2
Overall survival (months)
See this image and copyright information in PMC

References

    1. Jemal A, Siegel R, Ward E, et al. Cancer Statistics, 2009. CA Cancer J Clin 2009;59:225-49 - PubMed
    1. American Cancer Society. Facts and Figures 2010. Atlanta, GA, American Cancer Society, 2010.
    1. Yang GY, Wagner TD, Fuss M, et al. Multimodality approaches in pancreatic cancer. CA Cancer J Clin 2005;55:352-67 - PubMed
    1. Loehrer PJ, Powell ME, Cardenes HR, et al. A randomized phase III study of gemcitabine in combination with radiation therapy versus gemcitabine alone in patients with localized, unresectable pancreatic cancer: E4201 2008; ASCO Meeting Abstracts 2008;26:4506.
    1. Gastrointestinal Tumor Study Group Treatment of locally unresectable carcinoma of the pancreas: comparison of combined modality therapy (chemotherapy plus radiotherapy) to chemotherapy alone. J Natl Cancer Inst 1988;80:751-5 - PubMed