title: Neoadjuvant preoperative chemoradiation in patients with pancreatic cancer.
abstract: OBJECTIVE
  To assess the toxicity and efficacy of preoperative chemoradiation in pancreatic cancer.
  
  
  METHODS
  Between November 1996 and December 2001, 32 patients with biopsy-proven pancreatic adenocarcinoma (28 head; 4 body) were treated by chemoradiation consisting of either split-course therapy (two courses of 15 Gy separated by a 2-week break, n = 10) or standard-fractionation therapy (45 Gy during 5 weeks, n = 22). Concurrent chemotherapy included continuous infusion of 5-fluorouracil and a cisplatin bolus. Pancreatic resection was scheduled for 4-6 weeks after completion of chemoradiation treatment.
  
  
  RESULTS
  All 32 patients completed the chemoradiation protocol. Only 2 cases of Grade 3 toxicity (weight loss, vomiting) and one fatal Grade 4 infection occurred. Of the 32 patients, 19 underwent curative resection. Two patients had a complete pathologic response. One patient died 36 months after diagnosis of late treatment-related toxicity (acute superior mesenteric artery thrombosis) with no evidence of disease. The 2-year overall survival rate for the entire group and the resected patients was 37.3% (95% confidence interval 18.2-56.4%) and 59.3% (95% confidence interval 34.1-84.9%), respectively.
  
  
  CONCLUSIONS
  Preoperative chemoradiation with 5-fluorouracil and cisplatin is feasible and promising.
authors.affiliation: Department of Radiotherapy, Institut Paoli Calmettes, Marseille, France. magninv@marseille.fnclcc.fr
authors.forename: Valerie
authors.initials: V
authors.lastname: Magnin
authors.forename: Vincent
authors.initials: V
authors.lastname: Moutardier
authors.forename: Marie Helene
authors.initials: MH
authors.lastname: Giovannini
authors.forename: Bernard
authors.initials: B
authors.lastname: Lelong
authors.forename: Marc
authors.initials: M
authors.lastname: Giovannini
authors.forename: Frederic
authors.initials: F
authors.lastname: Viret
authors.forename: Genevieve
authors.initials: G
authors.lastname: Monges
authors.forename: Valerie Jeanne
authors.initials: VJ
authors.lastname: Bardou
authors.forename: Claude
authors.initials: C
authors.lastname: Alzieu
authors.forename: Jean Robert
authors.initials: JR
authors.lastname: Delpero
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D017538:Mesenteric Artery, Superior; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D018805:Sepsis / Q000209:etiology / Q000401:mortality; D016019:Survival Analysis; D013927:Thrombosis / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D005472:Fluorouracil