Chemotherapy and intensity-modulated radiation therapy for locally advanced pancreatic cancer achieves a high rate of R0 resection*

Authors

  • Florence Huguet Department of Radiation Oncology, Tenon Hospital, Hôpitaux Universitaires Est Parisien, University Pierre and Marie Curie Paris VI, Paris, France;  Department of Radiation Oncologyat Memorial Sloan-Kettering Cancer Center, New York, NY, USA
  • Carla Hajj Department of Radiation Oncologyat Memorial Sloan-Kettering Cancer Center, New York, NY, USA
  • Corrine B. Winston Department of Radiology at Memorial Sloan-Kettering Cancer Center, New York, NY, USA
  • Weiji Shi Department of Biostatisticsat Memorial Sloan-Kettering Cancer Center, New York, NY, USA
  • Zhigang Zhang Department of Biostatisticsat Memorial Sloan-Kettering Cancer Center, New York, NY, USA
  • Abraham J. Wu Department of Radiation Oncologyat Memorial Sloan-Kettering Cancer Center, New York, NY, USA
  • Eileen M. O’Reilly Department of Medical Oncologyat Memorial Sloan-Kettering Cancer Center, New York, NY, USA
  • Diane L. Reidy Department of Medical Oncologyat Memorial Sloan-Kettering Cancer Center, New York, NY, USA
  • Peter Allen Department ofSurgery at Memorial Sloan-Kettering Cancer Center, New York, NY, USA
  • Karyn A. Goodman Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA

DOI:

https://doi.org/10.1080/0284186X.2016.1245862

Abstract

Background: To assess local control, survival and conversion to resectability among locally advanced pancreatic cancer (LAPC) patients treated with induction chemotherapy (ICT) followed by chemoradiotherapy treatment using intensity-modulated radiation therapy (IMRT).

Material and methods: Between 2007 and 2012, 134 LAPC patients were treated with ICT followed by IMRT. After chemoradiotherapy, 40 patients received maintenance chemotherapy.

Results: With a median follow-up of 20 months, median overall survival (OS) was 23 months. One- and two-year OS was 85% and 47%, respectively. On multivariate analysis, progression of disease after IMRT was associated with worse OS. Cumulative incidence of local failure was 10% at one year and 36% at two years. Twenty-six patients (19%) underwent resection after chemoradiotherapy including 22 patients (85%) with negative margins. On multivariate analysis, response to IMRT was associated with surgery (p = .01). Acute grade 3-4 hematologic and non-hematologic toxicity rates were 26% and 4.5%, respectively.

Conclusion: IMRT is safe in patients with LAPC. Patients with non-progressive LAPC after ICT and who received IMRT had high rates of local control and prolonged survival.

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Published

2017-03-04

How to Cite

Huguet, F., Hajj, C., Winston, C. B., Shi, W., Zhang, Z., Wu, A. J., … Goodman, K. A. (2017). Chemotherapy and intensity-modulated radiation therapy for locally advanced pancreatic cancer achieves a high rate of R0 resection*. Acta Oncologica, 56(3), 384–390. https://doi.org/10.1080/0284186X.2016.1245862

Issue

Vol. 56 No. 3 (2017): Acta Oncologica

Section

Articles