title: [Chemoradiation therapy for stage IV pancreatic cancer].
abstract: BACKGROUND
  Pancreatic cancer is a malignant tumor with a poor prognosis. It frequently presents with locally advanced and distant metastasis at the time of diagnosis. Favorable results were obtained by performing intraoperative radiation therapy (IORT) and chemotherapy (administration of GEM) for the treatment of inoperable pancreatic cancer. A study was conducted on its efficacy as an adjuvant therapy for inoperable and advanced pancreatic cancer.
  
  
  METHODS
  Between May 1998 and December 2002, 40 patients with stage IV pancreatic cancer were treated at our institution. The study comprised background factors, adjuvant therapy and survival rate.
  
  
  RESULTS
  According to the treatment modality, the study population was classified into four groups: group A, consisting of 3 patients with localized unresectable tumors who had been treated with IORT: group B, 5 patients who underwent curative resection of primary tumor combined with IORT: group C, 6 patients who were administered GEM combined with IORT: group D, 26 patients not falling into groups A, B or C. The mean survival for group A, B, C and D was 10.3 months, 6.7 months, 16.8 months and 9.4 months, respectively. The 1-year survival rates were 0%, 0%, 80.0% and 19.3%, respectively. The mean survival and the 1-year survival rate were significantly better in group C than in the other groups. In group C, the tumor decreased in size, invasion of large vessels and pancreatic posterior evolution was suppressed, and 4 patients survived for 17 months or more.
  
  
  CONCLUSIONS
  Prolongation of the survival period was shown by concomitant IORT and administration of GEM for inoperable advanced pancreatic cancer. Thus, attempting to combine chemotherapy with IORT and giving additional consideration to the administration method was shown to provide adjuvant therapy that can be expected to be effective against stage IV inoperable pancreatic cancer.
authors: Dept. of Surgery, Kurume University, School of Medicine.
authors: Hiroyuki
authors: H
authors: Horiuchi
authors: Hiroto
authors: H
authors: Ishikawa
authors: Katsumi
authors: K
authors: Hayashi
authors: Shinji
authors: S
authors: Uchida
authors: Takahito
authors: T
authors: Kodama
authors: Kazunori
authors: K
authors: Nishimura
authors: Toshirou
authors: T
authors: Ogata
authors: Masafumi
authors: M
authors: Yasunaga
authors: Masaharu
authors: M
authors: Ohdo
authors: Msao
authors: M
authors: Hara
authors: Kouji
authors: K
authors: Okuda
authors: Hisahumi
authors: H
authors: Kinoshita
authors: Shigeaki
authors: S
authors: Aoyagi
authors: Kazuo
authors: K
authors: Shirouzu
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage; D015996:Survival Rate; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine