Conventional external irradiation alone as adjuvant treatment in resectable pancreatic cancer: results of a prospective study.
Between 1/85 and 1/90, 14 consecutive patients were entered into a prospective study of conventional adjuvant post-operative external beam radiotherapy after complete resection for a pancreatic adenocarcinoma. The surgical procedure was a Whipple resection in nine patients, a distal pancreatectomy in four patients and a total pancreatectomy in one patient. There were three T1b, eight T2 and three T3 tumours (UICC 1987); nodal involvement was present in five cases. The radiotherapy was delivered using a four-field box technique with a 23 x MV photon beam. All patients received a total dose of 54 Gy to the tumour bed. The mean treated volume was 900 cm3. Acute toxicities consisted mainly of weight loss (mean: 2 kg). Two patients had a grade 2 diarrhoea and two patients a grade 2 gastritis. Late effects were minimal and only observed in two patients. The overall locoregional recurrence (LR) rate was 50%. The median disease-free survival was 12 months, and the median survival was 23 months. This post-operative conventional radiotherapy treatment gives results that are comparable to the results of the GITSG-adjuvant study using a combination of split-course radiotherapy and 5-fluorouracil (5-FU).
Department of Radiotherapy, CHU Besançon, France.
J F
JF
Bosset
J J
JJ
Pavy
M
M
Gillet
G
G
Mantion
E
E
Pelissier
S
S
Schraub
D002285:Carcinoma, Intraductal, Noninfiltrating / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010183:Pancreatic Ducts; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011446:Prospective Studies; D011882:Radiotherapy, High-Energy; D015996:Survival Rate; D013997:Time Factors