title: Preoperative Chemoradiation in Locally Advanced Pancreatic Carcinoma: A Phase II Study.
abstract: BACKGROUND: Effectiveness and feasibility of preoperative chemoradiation (CRT) in locally advanced adenocarcinoma of the pancreas are evaluated. MATERIAL AND METHODS: 29 eligible of 37 registered patients were treated. 3d-Conformal external radiotherapy was delivered with a 1.8-Gy single dose and a total dose of 50.4 Gy plus 5.4 Gy boost. Simultaneous chemotherapy consisted of 5-fluorouracil and mitomycin C. RESULTS: Among 27 completely treated patients, 16 (59%) underwent surgery, 6 of them being irresectable intraoperatively. Ten patients (37%) had clear resection margins at Whipple's procedure. Eleven patients were not considered for surgery (7 still irresectable at restaging, 3 distant metastases, 1 refusal of surgery). Toxicity was predominantly hematological (grade 3: 30%, grade 4: 7%); furthermore, there was nausea/vomiting (grade 3: 20%, grade 4: 0%). No patient died perioperatively. The tumor-related overall survival rate was better for resected patients than for nonresected patients (50% vs. 6%, 2-year survival, p = 0.07), median overall survival was 9 months (median follow-up, 28 months). CONCLUSIONS: Neoadjuvant CRT without significant acute toxicity produced a resectability rate of 37% (all R0), which should be confirmed by randomized phase III studies. Copyright 2000 S. Karger GmbH, Freiburg
authors.affiliation: Klinik und Poliklinik für Strahlentherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg.
authors.forename: T.B.
authors.initials: TB
authors.lastname: Brunner
authors.forename: G.G.
authors.initials: GG
authors.lastname: Grabenbauer
authors.forename: S.
authors.initials: S
authors.lastname: Kastl
authors.forename: O.
authors.initials: O
authors.lastname: Herrmann
authors.forename: U.
authors.initials: U
authors.lastname: Baum
authors.forename: R.
authors.initials: R
authors.lastname: Fietkau
authors.forename: P.
authors.initials: P
authors.lastname: Klein
authors.forename: W.
authors.initials: W
authors.lastname: Bautz
authors.forename: T.
authors.initials: T
authors.lastname: Schneider
authors.forename: W.
authors.initials: W
authors.lastname: Hohenberger
authors.forename: R.
authors.initials: R
authors.lastname: Sauer