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Outcome of upfront combination chemotherapy followed by chemoradiation for locally advanced pancreatic adenocarcinoma.

Research paper by Michele M Reni, S S Cereda, G G Balzano, P P Passoni, A A Rognone, A A Zerbi, R R Nicoletti, E E Mazza, P G PG Arcidiacono, V V Di Carlo, E E Villa

Indexed on: 22 Apr '09Published on: 22 Apr '09Published in: Cancer Chemotherapy and Pharmacology



Abstract

The role and timing of chemotherapy and radiation for treating stage III pancreatic adenocarcinoma remains controversial.Treatment-naive patients with stage III non-resectable pancreatic adenocarcinoma were treated with PEFG/PEXG (cisplatin, epirubicin, 5-fluorouracil (F)/capecitabine (X), gemcitabine) or PDXG (docetaxel substituting epirubicin) regimen for 6 months followed by radiotherapy (50-60 Gy) with concurrent F or X or G.Ninety-one patients were registered between April 1997 and December 2007. Forty-three patients (47%) had a partial remission and 38 (42%) had a stable disease. Thirteen patients (14%) were radically resected yielding one pathologic complete remission. Median survival (OS) was 16.2 months. Median progression-free survival was 9.9 months. Pattern of failure consisted of isolated local failure (N = 26, 35%); both local and systemic failure (N = 14, 19%); isolated systemic failure (N = 35, 47%).Combination chemotherapy with four-drug regimens followed by chemoradiation was a feasible strategy showing relevant results in stage III pancreatic adenocarcinoma.

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