title: Phase II study of induction chemotherapy followed by chemoradiotherapy in patients with borderline resectable and unresectable locally advanced pancreatic cancer.
abstract: There is not a clear consensus regarding the optimal treatment of locally advanced pancreatic disease. There is a potential role for neoadjuvant therapy to treat micrometastatic disease with chemotherapy, as well as for the treatment of local disease with radiotherapy. We evaluated the safety and efficacy of induction chemotherapy with oxaliplatin and gemcitabine followed by a high weekly dose of gemcitabine concurrent to radiation therapy in patients with borderline resectable and unresectable locally advanced pancreatic cancer. In our study, 41 patients with pancreatic cancer were evaluated. In all cases an accurate pre-treatment staging was performed. Patients with evidence of metastatic disease were excluded, and thus a total of 34 patients were consequently enrolled. Of these, twenty-seven patients (80%) had locally advanced unresectable tumours, seven patients (20%) had borderline resectable disease. This protocol treatment represents a well-tolerated promising approach. Fifteen patients (55.5%) underwent surgical radical resection. With a median follow-up of 20 months, the median PFS and OS were 20 months and 19.2 months, respectively. The median OS for borderline resectable patients was 21.5 months compared with 14 months for unresectable patients (p = 0.3). Continued optimization in multimodality therapy and an accurate patient selection remain crucial points for the appropriate treatment of these patients.
authors.affiliation: Radiotherapy Unit, Campus Bio-Medico University, Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Fiore
authors.affiliation: Radiotherapy Unit, Campus Bio-Medico University, Rome, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Ramella
authors.affiliation: Department of General Surgery, Campus Bio-Medico University, Rome, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Valeri
authors.affiliation: Department of General Surgery, Campus Bio-Medico University, Rome, Italy.
authors.forename: Damiano
authors.initials: D
authors.lastname: Caputo
authors.affiliation: Radiotherapy Unit, Campus Bio-Medico University, Rome, Italy.
authors.forename: Barnaba
authors.initials: B
authors.lastname: Floreno
authors.affiliation: Radiotherapy Unit, Campus Bio-Medico University, Rome, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Trecca
authors.affiliation: Radiotherapy Unit, Campus Bio-Medico University, Rome, Italy.
authors.forename: Luca Eolo
authors.initials: LE
authors.lastname: Trodella
authors.affiliation: Radiotherapy Unit, Campus Bio-Medico University, Rome, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Trodella
authors.affiliation: Radiotherapy Unit, Campus Bio-Medico University, Rome, Italy.
authors.forename: Rolando Maria
authors.initials: RM
authors.lastname: D'Angelillo
authors.affiliation: Department of General Surgery, Campus Bio-Medico University, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Coppola
mesh_terms: D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D000093542:Gemcitabine
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000093542:Gemcitabine