Comparison of hyper-fractionated accelerated and standard fractionated radiotherapy with concomitant low-dose gemcitabine for unresectable pancreatic cancer.
BACKGROUND
Concurrent chemoradiotherapy with gemcitabine improves median survival for patients with unresectable pancreatic cancer. Recently, hyperfractionated accelerated radiotherapy (HART) has been used to treat these patients; however, the safety and efficacy are not well defined.


METHODS
The standard-fractionated radiotherapy (SFRT) group (n=17) received 50.4 Gy in 28 fractions of 1.8 Gy/day. The HART group (n=18) received 50 Gy in 40 fractions of 1.25 Gy twice/day. Concurrent gemcitabine was administered to both groups.


RESULTS
Median survival times were 11.3 months (SFRT) and 12.9 months (HART). One- and two-year survival rates were 37.5% and 18.8% (SFRT) and 47.1% and 17.6% (HART), respectively. The response rates did not differ significantly. The HART regimen required significantly fewer treatment days (35.5) than did the SFRT regimen (41.3). The toxicity profiles were similar.


CONCLUSIONS
The HART/gemcitabine regimen has equivalent efficacy and a shorter treatment time as compared with the SFRT/gemcitabine regimen for patients with unresectable pancreatic cancer.
Maemura
Kosei
K
Surgical Oncology and Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. kmaemura@hotmail.co.jp
Shinchi
Hiroyuki
H
Noma
Hidetoshi
H
Mataki
Yuko
Y
Kurahara
Hiroshi
H
Maeda
Shinichi
S
Hiraki
Yoshiyuki
Y
Nakajo
Masayuki
M
Natsugoe
Shoji
S
Takao
Sonshin
S