| Abstract: | Two hundred and twenty eight patients with carcinoma of the pancreas conrmed to the pancreas and peripancreatic area were randomly allocated to receive either radiation therapy alone to a dose of 6000 rad or radiation therapy delivered in conjunction with 5-Fuorouracil (FU). Fluorouracil was administered concomitant with the rust three days of 2000 rad increments of the radiation therapy and continued weekly indefinitely. The median survival of patients receiving radiation alone was 17.8 weeks compared to 35 weeks for patients receiving chemotherapy in conjunction with radiation (p<0.001). Within the group receiving concomitant chemotherapy, two dose levels of radiation were evaluated by random assignment: 4000 vs. 6000 rad. The superiority of 6000 rad plus 5-FU over 4000 rad plus 5-FU was established by median survival analysis, 39 weeks compared to 31 weeks and by time to progression, 31 weeks vs. 22 weeks (p < 0.09). The survival curves of the 4000 and the 6000 rad arm intercepted by approximately week 60 such that there was essentially no difference in the fraction of patients surviving beyond one year. Thus, the addition of chemotherapy to radiation for pancreatic cancer potentiates the therapeutic effect and promotes longer survival. The importance of radiation dose to the therapeutic benefit can be detected in median survival but is not sustained beyond one year. |
