title: Clinical impact of radiotherapy for locally advanced pancreatic cancer.
abstract: BACKGROUND
  Although a randomized controlled trial for locally advanced pancreatic cancer (PC) has demonstrated a survival advantage for treatment with gemcitabine alone, chemoradiotherapy remains the treatment of choice for locally advanced disease in Japan. The aim of this study was to compare the survival benefits associated with gemcitabine and concurrent chemoradiotherapy in locally advanced unresectable PC.
  
  
  METHODS
  Seventy-seven patients with locally advanced unresectable PC were retrospectively enrolled from April 2001 to December 2006. All cases were histologically proven, and patients received gemcitabine chemotherapy (n = 30) or concurrent chemoradiotherapy (based on 5-fluorouracil, n = 28, or gemcitabine, n = 19, as a radiosensitizer) at Aichi Cancer Center Hospital.
  
  
  RESULTS
  Patients who received chemoradiotherapy had significantly better performance status than those who had chemotherapy. Tumor response was 0% for chemotherapy and 13% chemoradiotherapy, but survival benefit was similar among patients in the chemotherapy group (overall response (OS) 12 months; progression-free survival (PFS), 3 months) and those in the chemoradiotherapy group (OS, 13 months; PFS, 5 months). Two-year survival was 21% for chemotherapy patients and 19% for chemoradiotherapy patients. Severe toxicities (Grade 3-4 National Cancer Institute-Common Toxicity Criteria, version 3.0) were significantly more frequent for chemoradiotherapy than for chemotherapy.
  
  
  CONCLUSIONS
  Gemcitabine chemotherapy showed similar survival benefit compared to 5-fluorouracil- and gemcitabine-based chemoradiotherapy.
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan. asawaki@aichi-cc.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Sawaki
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Hoki
authors.forename: Satoko
authors.initials: S
authors.lastname: Ito
authors.forename: Kazuya
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Nobumasa
authors.initials: N
authors.lastname: Mizuno
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hara
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Takagi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Yugo
authors.initials: Y
authors.lastname: Sawai
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kawai
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tajika
authors.forename: Tsuneya
authors.initials: T
authors.lastname: Nakamura
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamao
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D011878:Radiotherapy / Q000009:adverse effects; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine
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