title: Phase II study to assess the efficacy of conventionally fractionated radiotherapy followed by a stereotactic radiosurgery boost in patients with locally advanced pancreatic cancer.
abstract: 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.
authors.affiliation: Department of Radiation Oncology, Stanford University School of Medicine, 269 Campus Drive West, Stanford, CA 94305. akoong@stanford.edu
authors.forename: Albert C
authors.initials: AC
authors.lastname: Koong
authors.forename: Erin
authors.initials: E
authors.lastname: Christofferson
authors.forename: Quynh-Thu
authors.initials: QT
authors.lastname: Le
authors.forename: Karyn A
authors.initials: KA
authors.lastname: Goodman
authors.forename: Anthony
authors.initials: A
authors.lastname: Ho
authors.forename: Timothy
authors.initials: T
authors.lastname: Kuo
authors.forename: James M
authors.initials: JM
authors.lastname: Ford
authors.forename: George A
authors.initials: GA
authors.lastname: Fisher
authors.forename: Ralph
authors.initials: R
authors.lastname: Greco
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Norton
authors.forename: George P
authors.initials: GP
authors.lastname: Yang
mesh_terms: 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
chemical_list: D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil