Clinical impact of radiotherapy for locally advanced pancreatic cancer |
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Authors: | Akira Sawaki Noriyuki Hoki Satoko Ito Kazuya Matsumoto Nobumasa Mizuno Kazuo Hara Tadayuki Takagi Yuji Kobayashi Yugo Sawai Hiroki Kawai Masahiro Tajika Tsuneya Nakamura Kenji Yamao |
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Institution: | 1. Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, Nagoya, Aichi, 464-8681, Japan 2. Department of Gastroenterology, Bell Land General Hospital, Sakai, Japan 3. Department of Gastroenterology, Shimane University School of Medicine, Izumo, Japan 4. Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan
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Abstract: | Background Although a randomized controlled trial for locally advanced pancreatic cancer (PC) has demonstrated a survival advantage for treatment with gemcitabine alone, chemoradiotherapy remains the treatment of choice for locally advanced disease in Japan. The aim of this study was to compare the survival benefits associated with gemcitabine and concurrent chemoradiotherapy in locally advanced unresectable PC. Patients Seventy-seven patients with locally advanced unresectable PC were retrospectively enrolled from April 2001 to December 2006. All cases were histologically proven, and patients received gemcitabine chemotherapy (n = 30) or concurrent chemoradiotherapy (based on 5-fluorouracil, n = 28, or gemcitabine, n = 19, as a radiosensitizer) at Aichi Cancer Center Hospital. Results Patients who received chemoradiotherapy had significantly better performance status than those who had chemotherapy. Tumor response was 0% for chemotherapy and 13% chemoradiotherapy, but survival benefit was similar among patients in the chemotherapy group (overall response (OS) 12 months; progression-free survival (PFS), 3 months) and those in the chemoradiotherapy group (OS, 13 months; PFS, 5 months). Two-year survival was 21% for chemotherapy patients and 19% for chemoradiotherapy patients. Severe toxicities (Grade 3–4 National Cancer Institute-Common Toxicity Criteria, version 3.0) were significantly more frequent for chemoradiotherapy than for chemotherapy. Conclusions Gemcitabine chemotherapy showed similar survival benefit compared to 5-fluorouracil- and gemcitabine-based chemoradiotherapy. |
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