Neoadjuvant 5 fluorouracil-cisplatin chemoradiation effect on survival in patients with resectable pancreatic head adenocarcinoma: a ten-year single institution experience.
OBJECTIVE
It is the aim of this study to assess the outcome of patients who received neoadjuvant 5-fluorouracil-cisplatin chemoradiation (CRT) for stage I/III pancreatic adenocarcinoma.


METHODS
Eligible patients (n = 101) received radiation therapy (45 Gy) associated with continuous infusion of 5-fluorouracil accompanied by a cisplatin bolus.


RESULTS
Of the 102 patients enrolled in the study, 26 patients had progression of cancer during treatment and were deemed unresectable; 1 patient died during CRT of septic shock. Sixty-two of 75 remaining patients underwent pancreaticoduodenectomy. The overall median survival of all 102 patients in the study was 17 months, with a 5-year survival of 10%. For patients who underwent resection, the median survival was 23 months. Correspondingly, the median survival was 11 months for the 40 unresected patients (p = 0.002). The 5-year survivals for resected and unresected patients were 18 and 0% (p = 0.01), respectively. A complete pathological response to neoadjuvant CRT was noted for 8 patients (13%). Margin and lymph node positivity was present in 5 (8%) and 15 (24%) patients, respectively. There was documented local recurrence in 8 (13%) and distant recurrence in 36 (58%) patients, with the liver being the most common site.


CONCLUSIONS
Neoadjuvant 5-fluorouracil-based CRT had a limited impact on survival but appeared to be associated with improved local control.
Turrini
Olivier
O
Department of Surgical Oncology, Institut Paoli-Calmettes and Université de la Méditerranée Marseille, Marseille, France. turrinio@marseille.fnclcc.fr
Viret
Frédéric
F
Moureau-Zabotto
Laurence
L
Guiramand
Jérome
J
Moutardier
Vincent
V
Lelong
Bernard
B
de Chaisemartin
Cécile
C
Giovannini
Marc
M
Delpero
Jean-Robert
JR
D000230:Adenocarcinoma / Q000601:surgery / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005472:Fluorouracil / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods; D010179:Pancreas / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000601:surgery / Q000628:therapy*; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome
D002945:Cisplatin; D005472:Fluorouracil