Phase II study to assess the efficacy of conventionally fractionated radiotherapy followed by a stereotactic radiosurgery boost in patients with locally advanced pancreatic cancer.
OBJECTIVE
To determine the efficacy of concurrent 5-fluorouracil (5-FU) and intensity-modulated radiotherapy (IMRT) followed by body stereotactic radiosurgery (SRS) in patients with locally advanced pancreatic cancer.


METHODS
In this prospective study, all patients (19) had pathologically confirmed adenocarcinoma and were uniformly staged. Our treatment protocol consisted of 45 Gy IMRT with concurrent 5-FU followed by a 25 Gy SRS boost to the primary tumor.


RESULTS
Sixteen patients completed the planned therapy. Two patients experienced Grade 3 toxicity (none had more than Grade 3 toxicity). Fifteen of these 16 patients were free from local progression until death. Median overall survival was 33 weeks.


CONCLUSIONS
Concurrent IMRT and 5-FU followed by SRS in patients with locally advanced pancreatic cancer results in excellent local control, but does not improve overall survival and is associated with more toxicity than SRS, alone.
Koong
Albert C
AC
Department of Radiation Oncology, Stanford University School of Medicine, 269 Campus Drive West, Stanford, CA 94305. akoong@stanford.edu
Christofferson
Erin
E
Le
Quynh-Thu
QT
Goodman
Karyn A
KA
Ho
Anthony
A
Kuo
Timothy
T
Ford
James M
JM
Fisher
George A
GA
Greco
Ralph
R
Norton
Jeffrey
J
Yang
George P
GP
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D011446:Prospective Studies; D016634:Radiosurgery; D011879:Radiotherapy Dosage
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil