title: Chemotherapy as initial treatment of locally advanced unresectable pancreatic cancer: a valid option?
abstract: BACKGROUND
  Radio-chemotherapy is the standard treatment for locally advanced unresectable pancreatic cancer (LAPC). Chemotherapy has been shown to be effective in the treatment of metastatic disease and we therefore evaluated its use as a first-line treatment for LAPC.
  
  
  METHODS
  We carried out a retrospective analysis of all consecutive patients treated for LAPC (N=33) between July 1997 and April 2005, analysing the results of first-line chemotherapy (CT group) and radio-chemotherapy (RCT group) in this setting.
  
  
  RESULTS
  The first-line treatment was RCT in six patients (18.3%) and CT in 26 patients (78.8%). Secondary treatment was administered to nine patients of CT group with well-controlled disease: "closure" radio-chemotherapy for seven patients (26.9%) and secondary resection for three (12%). After a median follow-up of 27 months, 23 patients died (69.7%). Overall survival was 13.8 months [95% CI: 10.1-19.4] for the whole population, 9.5 months [95% CI: 4.6-] for the RCT and 18.0 months [95% CI: 12.4-25.5] for the CT. Overall survival for the CT patients undergoing secondary surgery or "consolidation" radio-chemotherapy was 28.8 months [95% CI: 13.8-].
  
  
  CONCLUSIONS
  First-line chemotherapy is a valid option for LAPC treatment, making it possible to identify the patients who may benefit from secondary resection or radio-chemotherapy.
authors.affiliation: Assistance Publique Hôpitaux de Paris, Hôpital Ambroise Paré, Boulogne-Billancourt, UVSQ - Association ADEBIOPHARM ER48, Paris.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Bachet
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mitry
authors.forename: Céline
authors.initials: C
authors.lastname: Lepère
authors.forename: Gilles
authors.initials: G
authors.lastname: Declety
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Vaillant
authors.forename: Henri
authors.initials: H
authors.lastname: Parlier
authors.forename: Yves
authors.initials: Y
authors.lastname: Otmezguine
authors.forename: Catherine
authors.initials: C
authors.lastname: Julie
authors.forename: Christophe
authors.initials: C
authors.lastname: Penna
authors.forename: Martin
authors.initials: M
authors.lastname: Housset
authors.forename: Bernard
authors.initials: B
authors.lastname: Nordlinger
authors.forename: Philippe
authors.initials: P
authors.lastname: Rougier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000628:therapy*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents