Capecitabine based postoperative accelerated chemoradiation of pancreatic carcinoma. A dose-escalation study

Authors

  • Alessio G. Morganti Radiotherapy Unit, Department of Oncology, “John Paul II” Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy; Palliative Therapies Unit, Department of Oncology, “John Paul II” Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
  • Vincenzo Picardi Radiotherapy Unit, Department of Oncology, “John Paul II” Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
  • Edy Ippolito Radiotherapy Unit, Department of Oncology, “John Paul II” Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
  • Mariangela Massaccesi Radiotherapy Unit, Department of Oncology, “John Paul II” Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
  • Gabriella Macchia Radiotherapy Unit, Department of Oncology, “John Paul II” Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
  • Francesco Deodato Radiotherapy Unit, Department of Oncology, “John Paul II” Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
  • Gian Carlo Mattiucci Department of Radiotherapy, Policlinico Universitario “A. Gemelli”, Catholic University, Rome, Italy
  • Luciana Caravatta Radiotherapy Unit, Department of Oncology, “John Paul II” Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
  • Liberato Di Lullo Department of Oncology, “F. Veneziale” General Hospital, Isernia, Italy
  • Gianfranco Giglio Department of Oncology, “A. Cardarelli” General Hospital Campobasso, Italy
  • Rosa Tambaro Palliative Therapies Unit, Department of Oncology, “John Paul II” Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
  • Samantha Mignogna Palliative Therapies Unit, Department of Oncology, “John Paul II” Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
  • Paola Caprino Surgery Unit, Department of Oncology, “John Paul II” Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
  • Marcello Ingrosso Endoscopy Unit, Department of Oncology, “John Paul II” Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
  • Luigi Sofo Surgery Unit, Department of Oncology, “John Paul II” Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
  • Numa Cellini Department of Radiotherapy, Policlinico Universitario “A. Gemelli”, Catholic University, Rome, Italy
  • Vincenzo Valentini Department of Radiotherapy, Policlinico Universitario “A. Gemelli”, Catholic University, Rome, Italy

DOI:

https://doi.org/10.3109/02841861003660056

Abstract

The objective of this study was to evaluate the safety of escalating up to 55 Gy within five weeks, the dose of external beam radiotherapy to the previous tumor site concurrently with a fixed daily dose of capecitabine, in patients with resected pancreatic cancer. Material and methods. Patients with resected pancreatic carcinoma were eligible for this study. Capecitabine was administered at a daily dose of 1600 mg/m 2. Regional lymph nodes received a total radiation dose of 45 Gy with 1.8 Gy per fractions. The starting radiation dose to the tumor bed was 50.0 Gy (2.0 Gy/fraction, 25 fractions). Escalation was achieved up to a total dose of 55.0 Gy by increasing the fraction size by 0.2 Gy (2.2 Gy/fraction), while keeping the duration of radiotherapy to five weeks (25 fractions). A concomitant boost technique was used. Dose limiting toxicity (DLT) was defined as any grade>3 hematologic toxicity, grade>2 liver, renal, neurologic, gastrointestinal, or skin toxicity, by RTOG criteria, or any toxicity producing prolonged (> 10 days) radiotherapy interruption. Results and discussion. Twelve patients entered the study (median age: 64 years). In the first cohort (six patients), no patient experienced DLT. Similarly in the second cohort, no DLT occurred. All 12 patients completed the planned regimen of therapy. Nine patients experienced grade 1-2 nausea and/or vomiting. Grade 2 hematological toxicity occurred in four patients. The results of our study indicate that a total radiation dose up to 55.0 Gy/5 weeks can be safely administered to the tumor bed, concurrently with capecitabine (1600 mg/m 2) in patients with resected pancreatic carcinoma.

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Published

2010-01-01

How to Cite

Morganti, A. G., Picardi, V., Ippolito, E., Massaccesi, M., Macchia, G., Deodato, F., … Valentini, V. (2010). Capecitabine based postoperative accelerated chemoradiation of pancreatic carcinoma. A dose-escalation study. Acta Oncologica, 49(4), 418–422. https://doi.org/10.3109/02841861003660056

Issue

Vol. 49 No. 4 (2010): Acta Oncologica

Section

Articles