title: 32P as an adjunct to standard therapy for locally advanced unresectable pancreatic cancer: a randomized trial.
abstract: This prospective randomized trial was undertaken to determine the added efficacy of (32)P in treating locally advanced unresectable pancreatic cancer. Thirty patients with biopsy proven locally advanced unresectable adenocarcinoma of the pancreas were assessable after receiving 5-fluorouracil and radiation therapy with or without (32)P, followed by gemcitabine. Intratumoral (32)P dose was determined by tumor size and volume and was administered at months 0, 1, 2, 6, 7, and 8. Tumor cross-sectional area and liquefaction were determined at intervals by computed tomography scan. Tumor liquefaction occurred in 78% of patients receiving (32)P and in 8% of patients not receiving (32)P, although tumor cross-sectional area did not decrease. Serious adverse events occurred more often per patient for patients receiving (32)P (4.2 +/- 3.1 vs. 1.8 +/- 1.9; p = 0.03) leading to more hospitalizations. Death was because of disease progression (23 patients), gastrointenstinal hemorrhage (4 patients), and stroke (1 patient). One patient not receiving (32)P and one receiving (32)P are alive at 28 and 13 months, respectively. (32)P did not prolong survival (7.4 +/- 5.5 months with (32)P vs. 11.5 +/- 8.0 months without (32)P, p = 0.16). (32)P promoted tumor liquefaction, but did not decrease tumor size. Intratumoral (32)P was associated with more serious adverse events and did not improve survival for locally advanced unresectable pancreatic cancer.
authors.affiliation: Tampa General Hospital, University of South Florida, Tampa, FL, USA. arosemur@health.usf.edu
authors.forename: Alexander
authors.initials: A
authors.lastname: Rosemurgy
authors.forename: German
authors.initials: G
authors.lastname: Luzardo
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cooper
authors.forename: Carl
authors.initials: C
authors.lastname: Bowers
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Zervos
authors.forename: Mark
authors.initials: M
authors.lastname: Bloomston
authors.forename: Sam
authors.initials: S
authors.lastname: Al-Saadi
authors.forename: Robert
authors.initials: R
authors.lastname: Carroll
authors.forename: Hemant
authors.initials: H
authors.lastname: Chheda
authors.forename: Larry
authors.initials: L
authors.lastname: Carey
authors.forename: Steven
authors.initials: S
authors.lastname: Goldin
authors.forename: Shane
authors.initials: S
authors.lastname: Grundy
authors.forename: Bruce
authors.initials: B
authors.lastname: Kudryk
authors.forename: Bruce
authors.initials: B
authors.lastname: Zwiebel
authors.forename: Thomas
authors.initials: T
authors.lastname: Black
authors.forename: John
authors.initials: J
authors.lastname: Briggs
authors.forename: Paul
authors.initials: P
authors.lastname: Chervenick
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D010761:Phosphorus Radioisotopes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D010761:Phosphorus Radioisotopes; D005472:Fluorouracil