title: Concomitant chemoradiotherapy with low-dose weekly gemcitabine for nonmetastatic unresectable pancreatic cancer.
abstract: OBJECTIVE
  This study aimed to demonstrate the efficacy and tolerability of low-dose weekly gemcitabine as a radiosensitizer in unresectable pancreatic cancer patients treated with chemoradiotherapy.
  
  
  METHODS
  Twenty-four histologically confirmed pancreatic carcinoma patients (female/male: 10/14, median age: 60) were evaluated. Seven (29%) patients received gemcitabine either as a single agent or in combination prior to chemoradiotherapy. Concurrent 75 mg/m2 gemcitabine was infused weekly. Radiotherapy was delivered to the primary tumor and positive lymphatics with 3D-conformal radiotherapy to a total dose of 4500 cGy. Local progression-free survival, distant metastasis-free survival and overall survival were evaluated by Kaplan-Meier method.
  
  
  RESULTS
  Median follow-up was 36 weeks. Median local progression-free survival, distant metastasis-free survival and overall survival were 22 weeks (95% confidence interval [CI]: 5-59 weeks), 19 weeks (95%CI: 6.9-31 weeks) and 36 weeks (95%CI: 28-43 weeks), respectively. All patients completed radiotherapy as scheduled. Concurrent gemcitabine was given fully in 58.3% of patients. Gemcitabine was terminated in four (16.6%) patients due to grade 3 neutropenia (n=1), grade 3 nausea/vomiting (n=2) or patient's reluctance (n=1). Patients with local response and stable disease to chemoradiotherapy revealed a median survival of 39 weeks (95%CI: 30-47.9 weeks) compared to 36 weeks (95%CI: 9.7-62.2 weeks) in patients with locally progressive disease (p=0.52). Pain was improved in 50% of patients.
  
  
  CONCLUSIONS
  Weekly low-dose radiosensitizing gemcitabine is effective and safe in unresectable pancreatic cancer patients.
authors.affiliation: Departments of, Radiation Oncology, Marmara University School of Medicine, İstanbul. bmatasoy@yahoo.com
authors.forename: Beste Melek
authors.initials: BM
authors.lastname: Atasoy
authors.forename: Faysal
authors.initials: F
authors.lastname: Dane
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Uçüncü Kefelı
authors.forename: Hale
authors.initials: H
authors.lastname: Cağlar
authors.forename: Asım
authors.initials: A
authors.lastname: Cıngı
authors.forename: Nazım Serdar
authors.initials: NS
authors.lastname: Turhal
authors.forename: Ufuk
authors.initials: U
authors.lastname: Abacioğlu
authors.forename: Cumhur
authors.initials: C
authors.lastname: Yeğen
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage* / Q000009:adverse effects; D011878:Radiotherapy / Q000379:methods; D012189:Retrospective Studies; D000093542:Gemcitabine
chemical_list: D011838:Radiation-Sensitizing Agents; D003841:Deoxycytidine; D000093542:Gemcitabine