title: [Examination of resectable and borderline pancreatic cancer treated with neoadjuvant chemoradiation therapy].
abstract: OBJECTIVE
  The purpose of this study was to determine the effect of neoadjuvant chemotherapy( NAC) and chemoradiation therapy( NAC-RT) for the treatment of potentially resectable( PR) and borderline resectable( BR) pancreatic cancer.
  
  
  METHODS
  Patients with PR (n=14) and BR (n=13) pancreatic cancer who received NAC (n=15) or NAC-RT (n=12) were enrolled in our study. NAC comprised 2 cycles of S-1 or S-1 plus gemcitabine, and NAC-RT comprised hyperaccelerated radiation therapy and S-1 chemotherapy.
  
  
  RESULTS
  According to the Response Evaluation Criteria in Solid Tumors (RECIST), partial response was observed in 10 patients( 37%); stable disease( SD), in 11 patients( 41%); and progressive disease (PD), in 6 patients (22%). The rates of curative surgery in patients with PR and BR pancreatic cancer were 57% and 38%, respectively. Curative surgery was performed in 8 patients with PR pancreatic cancer. Downstaging was observed in 3 patients and upstaging was observed in 1 patient. During the postoperative course, peritoneal dissemination was detected in 2 patients at 4 months after surgery. One patient survived for more than 3 years. Curative surgery was performed in 5 patients with BR pancreatic cancer. Downstaging was observed in 4 patients, and upstaging was observed in 1 patient. During the postoperative course, recurrence was detected in 3 patients and the remaining 2 patients survived with a recurrence-free status.
  
  
  CONCLUSIONS
  The results of the present study indicate that NAC-RT may be useful for the treatment of patients with PR or BR pancreatic cancer. However, this protocol has disadvantages in that the possibility of resectability might be compromised and early recurrence might occur. Thus, this protocol warrants further evaluation.
authors.affiliation: Dept. of Digestive, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mataki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shinchi
authors.forename: Kosei
authors.initials: K
authors.lastname: Maemura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurahara
authors.forename: Yota
authors.initials: Y
authors.lastname: Kawasaki
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Desaki
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ueno
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sakoda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iino
authors.forename: Michiyo
authors.initials: M
authors.lastname: Higashi
authors.forename: Sonshin
authors.initials: S
authors.lastname: Takao
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D059248:Chemoradiotherapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010094:Oxonic Acid / Q000627:therapeutic use; D010190:Pancreatic Neoplasms / Q000628:therapy*; D005641:Tegafur / Q000627:therapeutic use; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine