Interferon-based chemoradiation followed by gemcitabine for resected pancreatic adenocarcinoma: long-term follow-up |
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Authors: | Kerri A Ohman Jingxia Liu David C Linehan Marcus C Tan Benjamin R Tan Ryan C Fields Steven M Strasberg William G Hawkins |
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Institution: | 1. Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA;2. Division of Public Health Sciences, Section of Oncologic Biostatistics, Washington University School of Medicine, St. Louis, MO, USA;3. Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA;4. Department of Surgery, University of South Alabama Health System, Mobile, AL, USA;5. Division of Medical Oncology, Washington University School of Medicine, St. Louis, MO, USA;6. Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital, and Washington University School of Medicine, St. Louis, MO, USA |
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Abstract: | To report long-term follow up of a phase II, single-arm trial of resectable pancreatic ductal adenocarcinoma (PDAC) treated with adjuvant interferon-based chemoradiation followed by gemcitabine to determine survival, recurrence, and complications.MethodsFrom 2002 to 2005, 53 patients with PDAC underwent pancreaticoduodenectomy and received adjuvant interferon-based chemoradiation consisting of external-beam irradiation and simultaneous 3-drug chemotherapy of continuous daily 5-fluorouracil infusion, weekly intravenous bolus cisplatin, and subcutaneous interferon-α, followed by two months of weekly intravenous gemcitabine.ResultsActual overall survival for the 5- and 10-year periods were 26% and 10%, respectively, with a median overall survival of 25 months (95% CI: 16.4–38.5). Adverse prognostic factors on multivariate analysis were positive tumor margin (p < 0.035), lymphovascular invasion (p < 0.015), and perineural invasion (p < 0.026). Median time to recurrence was 11 months. Positive tumor margin was associated with lymph node involvement (p < 0.005), portal vein resection (p < 0.038), and metastases (p < 0.018). Late complications were frequent and predominated by gastrointestinal and infectious complications.ConclusionsAdjuvant interferon-based chemoradiation for PDAC improves long-term survival compared to standard therapy. However, recurrence rates and long-term complications remain high, thus further studies are indicated to assess patient characteristics that indicate a favorable treatment profile. |
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Keywords: | Correspondence: William G Hawkins Department of Surgery and the Alvin J Siteman Cancer Center Barnes-Jewish Hospital and Washington University School of Medicine St Louis 660 S Euclid Ave Box 8109 Saint Louis MO 63110 USA |
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