title: Pancreatic cancer: treatment with neutron irradiation alone and with chemotherapy.
abstract: OBJECTIVE
  To evaluate neutron irradiation alone and with chemotherapy to treat inoperable pancreatic cancer.
  
  
  METHODS
  Between 1977 and 1994, 173 patients (60 men, 113 women, aged 43-77 years [mean, 59 years]) with unresectable adenocarcinoma of the exocrine pancreas were treated, 106 with neutron irradiation alone and 67 with concomitant chemotherapy (fluorouracil [5-FU]). At follow-up, which was performed at 2-month intervals until death (range, 4-64 months), clinical status was recorded, noting the presence of overt metastasis and the onset of any major complications. Actuarial (Kaplan-Meier) survival tables were computed for both groups.
  
  
  RESULTS
  For neutron irradiation alone and neutron irradiation plus chemotherapy, median survival times were 6 months and 9 months, respectively; actuarial survival rates at 3 years were 0 and 7%, respectively; major reactions (grade 3 or higher [scale of the Radiation Therapy Oncology Group and European Organization for Research and Treatment of Cancer]) occurred in 19 (18%) and 17 (25%) patients, respectively; and severe complications (grade 4) occurred in five (5%) and four (6%) patients, respectively. Most deaths were due to metastatic disease rather than to failure of local control.
  
  
  CONCLUSIONS
  Neutron irradiation obliterated pancreatic adenocarcinoma at the primary site but has no effect on long-term survival. With more effective concomitant chemotherapy to prevent metastasis, local control of pancreatic cancer with neutron irradiation could lead to increased long-term survival.
authors: Fermilab National Accelerator Laboratory, Neutron Therapy Department, Batavia, IL 60510-0500, USA.
authors: L
authors: L
authors: Cohen
authors: F R
authors: FR
authors: Hendrickson
authors: A J
authors: AJ
authors: Lennox
authors: T K
authors: TK
authors: Kroc
authors: M A
authors: MA
authors: Hatcher
authors: B R
authors: BR
authors: Bennett
mesh_terms: D000206:Actuarial Analysis; D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009502:Neutrons / Q000009:adverse effects / Q000627:therapeutic use*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil