title: Toxicities and effects of involved-field irradiation with concurrent cisplatin for unresectable carcinoma of the pancreas.
abstract: OBJECTIVE
  To evaluate local effects and acute toxicities of involved field irradiation with concurrent cisplatin (CDDP) for unresectable pancreatic carcinoma.
  
  
  METHODS
  Thirty-three patients with unresectable pancreatic carcinoma were treated with chemoradiotherapy. Sixteen were Stage IVA; 17 were Stage IVB. The total prescribed dose of radiotherapy was 50 Gy/25 fractions or 50.4 Gy/28 fractions, using a three-dimensionally determined involved-field that included only the primary tumor and clinically enlarged lymph nodes. Twelve patients received a daily i.v. infusion of CDDP; 21 patients received a combination of CDDP and 5-fluorouracil either i.v. or through the proper hepatic artery.
  
  
  RESULTS
  Twenty-seven (82%) patients completed planned chemoradiotherapy. Nausea was the most frequent complaint. No patient experienced Grade 4 toxicities. More than half achieved pain relief. As for the primary site, only 4 patients (12%) achieved a partial response at 4 weeks; however, 3 additional patients attained >50% tumor reduction thereafter. The most frequent site of disease progression was the liver, and only 3 patients developed local progression alone. No regional lymph nodal progression outside the treatment field was seen. Median survival time and survival at 1 year were 7.1 months and 27%, respectively, for the entire group. Difference in overall survival between patients with and without distant metastases was significant (p = 0.01).
  
  
  CONCLUSIONS
  Involved-field irradiation with concurrent daily CDDP was well tolerated without compromising locoregional effects.
authors: Department of Radiology, Chiba University Graduate School of Medicine, Chuou-ku, Chiba-City, Chiba, Japan.
authors: Hiroyuki
authors: H
authors: Kawakami
authors: Takashi
authors: T
authors: Uno
authors: Kouichi
authors: K
authors: Isobe
authors: Naoyuki
authors: N
authors: Ueno
authors: Takashi
authors: T
authors: Aruga
authors: Kentaro
authors: K
authors: Sudo
authors: Taketo
authors: T
authors: Yamaguchi
authors: Hiromitsu
authors: H
authors: Saisho
authors: Tetsuya
authors: T
authors: Kawata
authors: Hisao
authors: H
authors: Ito
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy; D000230:Adenocarcinoma / Q000188:drug therapy* / Q000532:radiotherapy* / Q000556:secondary; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001416:Back Pain / Q000188:drug therapy; D018395:CA-19-9 Antigen / Q000097:blood; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D016019:Survival Analysis; D017211:Treatment Failure
chemical_list: D018395:CA-19-9 Antigen; D002945:Cisplatin; D005472:Fluorouracil