Long-term results of concurrent radiotherapy and UFT in patients with locally advanced pancreatic cancer.
BACKGROUND
Definition and treatment options for locally advanced non-resectable pancreatic cancer (LAPC) vary. Treatment options range from palliative chemotherapy to chemoradiotherapy (CRT). Several studies have shown that a number of patients become resectable after complementary treatment prior to surgery.


METHODS
From 2001 to 2005, 63 consecutive patients with unresectable LAPC received CRT. CRT was given at a dose of 50 Gy/27 fractions, combined with UFT (300 mg/m(2)/day) and folinic acid. Re-evaluation of resectability was planned 4-6 weeks after completion of CRT.


RESULTS
Fifty-eight patients completed all 27 treatment fractions. Toxicity was generally mild, with 18 patients experiencing CTCAE grade 3 or worse acute reactions. One patient died following a treatment-related infection. Two patients developed grade 4 upper GI bleeding. Median survival was 10.6 (8-13) months. Eleven patients underwent resection, leading to a resection rate of 17%, and a median survival of 46 (23-nr) months. All 11 patients had a R0 resection. Median survival for the patients not resected was 8.8 (8-12) months.


CONCLUSIONS
CRT with 50 Gy combined with UFT, is a well-tolerated and effective treatment for patients with LAPC. R0 resection was possible in 17% leading to a long median survival of 46 months in resected patients.
Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, Odense C, Denmark. jon.bjerregaard@ouh.regionsyddanmark.dk
Jon K
JK
Bjerregaard
Michael B
MB
Mortensen
Helle A
HA
Jensen
Claus
C
Fristrup
Birgitte
B
Svolgaard
Katrine R
KR
Schønnemann
Tine P
TP
Hansen
Morten
M
Nielsen
Jørgen
J
Johansen
Per
P
Pfeiffer
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000628:therapy*; D005641:Tegafur / Q000009:adverse effects / Q000627:therapeutic use; D014498:Uracil / Q000009:adverse effects / Q000627:therapeutic use
D005641:Tegafur; D014498:Uracil