title: Preoperative chemoradiotherapy, surgery and adjuvant therapy for resectable pancreatic cancer.
abstract: OBJECTIVE
  In order to improve the poor prognosis of pancreatic cancer, a combination therapy consisting of preoperative chemoradiotherapy, surgery and postoperative chemotherapy may be an ideal strategy; nevertheless, the influence of preoperative therapy to postoperative therapy is not investigated.
  
  
  METHODS
  Thirty patients with resectable pancreatic ductal adenocarcinoma were enrolled. A 40Gy of radiation (2Gy/day x 20 fractions/4 weeks) was administered together with intravenous infusion of gemcitabine (800mg/m2, days 1, 8 and 15) before surgery. Surgery was performed 3-7 weeks after the final fraction of radiation, and postoperative chemotherapy consisting of 1000mg/m2 gemcitabine (days 1, 8 and 15 every 4 weeks for 6 cycles) was started within 8 weeks after surgery.
  
  
  RESULTS
  All 30 patients successfully completed preoperative therapy. Re-staging after such therapy showed radiologically unresectable disease in 4 patients and 1 patient rejected surgery. Among the 25 patients who underwent laparotomy, 21 underwent curative resection. After curative resection, 4 were inadequate in performance status, thus postoperative therapy could not be started. Ten patients completed postoperative adjuvant therapy.
  
  
  CONCLUSIONS
  The combination therapy for resectable pancreatic cancer seems a feasible and effective approach, though preoperative therapy may reduce the feasibility of postoperative therapy.
authors: Hidetoshi
authors: H
authors: Eguchi
authors: Hiroaki
authors: H
authors: Nagano
authors: Masahiro
authors: M
authors: Tanemura
authors: Yutaka
authors: Y
authors: Takeda
authors: Shigeru
authors: S
authors: Marubashi
authors: Shogo
authors: S
authors: Kobayashi
authors: Koichi
authors: K
authors: Kawamoto
authors: Hiroshi
authors: H
authors: Wada
authors: Naoki
authors: N
authors: Hama
authors: Hirofumi
authors: H
authors: Akita
authors: Masaki
authors: M
authors: Mori
authors: Yuichiro
authors: Y
authors: Doki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D011183:Postoperative Complications; D011379:Prognosis; D016896:Treatment Outcome