Adjuvant therapy of resected adenocarcinoma of the pancreas - PubMed (original) (raw)
Adjuvant therapy of resected adenocarcinoma of the pancreas
R Whittington et al. Int J Radiat Oncol Biol Phys. 1991 Oct.
Abstract
Seventy-two patients underwent resections of pancreatic carcinomas between 1981 and 1989 at the Hospital of the University of Pennsylvania and were evaluable for follow-up. There were three treatment groups as treatment policies evolved. Initially, patients were observed after surgery without adjuvant treatment (Group 1-33 patients). Beginning in 1984, patients were offered adjuvant radiation therapy postoperatively (Group 2-19 patients) and eight of these patients also received 5-FU as an IV bolus on the first 3 days of the first and fifth weeks of treatment. Twenty patients were treated with chemosensitized radiation therapy following surgery using 96-hour 5-FU infusions during the first and fifth weeks of treatment. There were four postoperative deaths, which are excluded from the analysis, and sites of failure could not be determined for five other patients. Among evaluable patients, local recurrences occurred in 85% of the patients in group 1, 55% of the patients in group 2, and 25% of the patients in group 3. The 2-year survival was 35% in group 1, 30% in group 2, and 43% in group 3. Patients with involved surgical margins had a poor survival; only 2 of these 16 patients survived longer than 18 months. Among patients with negative margins, the 2-year survival is 41% in group 1, 33% in group 2, and 59% in group 3. Although the number of patients is smaller, the 3-year survival is 22% in group 1, 11% in group 2, and 47% in group 3. Chemosensitized irradiation is well tolerated in these patients. The major challenge in this group of patients is nutritional maintenance. There was no other significant toxicity. The trend in these observations suggests that survival following pancreatic resection is substantially improved with the addition of adjuvant chemosensitized radiation therapy.
Similar articles
- Intensified adjuvant combined modality therapy for resected periampullary adenocarcinoma: acceptable toxicity and suggestion of improved 1-year disease-free survival.
Chakravarthy A, Abrams RA, Yeo CJ, Korman LT, Donehower RC, Hruban RH, Zahurek ML, Grochow LB, O'Reilly S, Hurwitz H, Jaffee EM, Lillemoe KD, Cameron JL. Chakravarthy A, et al. Int J Radiat Oncol Biol Phys. 2000 Nov 1;48(4):1089-96. doi: 10.1016/s0360-3016(00)00755-0. Int J Radiat Oncol Biol Phys. 2000. PMID: 11072167 - Pancreaticoduodenectomy for pancreatic adenocarcinoma: postoperative adjuvant chemoradiation improves survival. A prospective, single-institution experience.
Yeo CJ, Abrams RA, Grochow LB, Sohn TA, Ord SE, Hruban RH, Zahurak ML, Dooley WC, Coleman J, Sauter PK, Pitt HA, Lillemoe KD, Cameron JL. Yeo CJ, et al. Ann Surg. 1997 May;225(5):621-33; discussion 633-6. doi: 10.1097/00000658-199705000-00018. Ann Surg. 1997. PMID: 9193189 Free PMC article. Clinical Trial. - Impact of adjuvant therapy on locally advanced adenocarcinoma of the stomach.
Regine WF, Mohiuddin M. Regine WF, et al. Int J Radiat Oncol Biol Phys. 1992;24(5):921-7. doi: 10.1016/0360-3016(92)90476-x. Int J Radiat Oncol Biol Phys. 1992. PMID: 1447035 Clinical Trial. - Adjuvant postoperative radiation therapy +/- 5-FU in resected carcinoma of the pancreas.
Foo ML, Gunderson LL. Foo ML, et al. Hepatogastroenterology. 1998 May-Jun;45(21):613-23. Hepatogastroenterology. 1998. PMID: 9684106 Review. - Adjuvant chemoradiotherapy in pancreatic adenocarcinoma.
Thomas PR. Thomas PR. Hepatogastroenterology. 1998 May-Jun;45(21):610-2. Hepatogastroenterology. 1998. PMID: 9684105 Review.
Cited by
- The role of chemoradiation for patients with resectable or potentially resectable pancreatic cancer.
Kimple RJ, Russo S, Monjazeb A, Blackstock AW. Kimple RJ, et al. Expert Rev Anticancer Ther. 2012 Apr;12(4):469-80. doi: 10.1586/era.12.18. Expert Rev Anticancer Ther. 2012. PMID: 22500684 Free PMC article. Review. - Adjuvant therapy for pancreatic cancer.
Douglass HO Jr. Douglass HO Jr. World J Surg. 1995 Mar-Apr;19(2):270-4. doi: 10.1007/BF00308637. World J Surg. 1995. PMID: 7754634 Review. - Results of adjuvant therapy in resected pancreatic cancer.
Andrén-Sandberg A, Bäckman PL, Andersson R. Andrén-Sandberg A, et al. Int J Pancreatol. 1997 Feb;21(1):31-8. doi: 10.1007/BF02785917. Int J Pancreatol. 1997. PMID: 9127171 Review. - Induction of VX2 para-renal carcinoma in rabbits: generation of animal model for loco-regional treatments of solid tumors.
Bimonte S, Leongito M, Piccirillo M, Tamma ML, Vallifuoco M, Bracco A, Mancini A, Di Napoli D, Castaldo S, Cozzolino S, Iacobellis F, Grassi R, Granata V, Lastoria S, Curley S, Izzo F. Bimonte S, et al. Infect Agent Cancer. 2016 Dec 1;11:62. doi: 10.1186/s13027-016-0103-8. eCollection 2016. Infect Agent Cancer. 2016. PMID: 27980609 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical