title: GEMOX plus tomotherapy for unresectable locally advanced pancreatic cancer.
abstract: OBJECTIVE
  The aim of this prospective phase II study was to evaluate the effect of neoadjuvant GEMOX plus helical tomotherapy on the resectability of locally advanced pancreatic cancer.
  
  
  METHODS
  Between November 2004 and July 2008, 33 enrolled patients received gemcitabine (GEM) 1000 mg/m2 on day 1, and oxaliplatin (OX) 100 mg/m2 on day 2, every two weeks for 3-4 cycles. This was followed by radiotherapy (25 Gy, 5 fractions), 15 days after completion of GEMOX. Patients then received a further 3-4 cycles of GEMOX, underwent restaging and were evaluated for surgery. Potentially resectable patients were submitted to surgery, while unresectable responders received further GEMOX and radiotherapy.
  
  
  RESULTS
  Toxicity to GEMOX was similar to that reported elsewhere and radiotherapy was also well tolerated. After treatment, one patient achieved a complete response, 14 had a partial response, 11 showed a stable disease, 6 progressed, and one was not evaluable. Eight patients (24%) underwent surgical laparotomy (7 radical pancreatic resections and one explorative laparotomy).
  
  
  CONCLUSIONS
  Our study shows the feasibility and potential efficacy of the GEMOX plus helical tomotherapy regimen in unresectable locally advanced pancreatic cancer.
authors.affiliation: Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T), Meldola, Italy. c.milandri@gmail.com
authors.forename: Carlo
authors.initials: C
authors.lastname: Milandri
authors.forename: Rolando
authors.initials: R
authors.lastname: Polico
authors.forename: Domenico
authors.initials: D
authors.lastname: Garcea
authors.forename: Alessando
authors.initials: A
authors.lastname: Passardi
authors.forename: Andrea
authors.initials: A
authors.lastname: Gardini
authors.forename: Antonino
authors.initials: A
authors.lastname: Romeo
authors.forename: Emanuela
authors.initials: E
authors.lastname: Scarpi
authors.forename: Paola
authors.initials: P
authors.lastname: Rosetti
authors.forename: Laura
authors.initials: L
authors.lastname: Ridolfi
authors.forename: Giuliano
authors.initials: G
authors.lastname: La Barba
authors.forename: Marianna
authors.initials: M
authors.lastname: Ricci
authors.forename: Dino
authors.initials: D
authors.lastname: Amadori
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011880:Radiotherapy Planning, Computer-Assisted; D014057:Tomography, X-Ray Computed; D000093542:Gemcitabine
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000093542:Gemcitabine