Efficacy and safety of preoperative 5-fluorouracil, cisplatin, and mitomycin C in combination with radiotherapy in patients with resectable and borderline resectable pancreatic cancer: A long-term follow-up study

Yutaka Endo, Minoru Kitago, Koichi Aiura, Masahiro Shinoda, Hiroshi Yagi, Yuta Abe, Go Oshima, Shutaro Hori, Yutaka Nakano, Osamu Itano, Junichi Fukada, Yohei Masugi, Yuko Kitagawa

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Abstract

Background: We aimed to evaluate the efficacy and safety of 5-fluorouracil-based neoadjuvant chemoradiotherapy (NACRT) in patients with resectable/borderline resectable pancreatic ductal adenocarcinoma (PDAC). Methods: This retrospective study investigated the clinicopathological features and > 5-year survival of patients with T3/T4 PDAC who underwent NACRT at our institute between 2003 and 2012. Results: Seventeen resectable and eight borderline resectable patients were included. The protocol treatment completion and resection rates were 92.0% and 68.0%, respectively. Two patients failed to complete chemotherapy owing to cholangitis or anorexia. Common grade 3 toxicities included anorexia (12%), neutropenia (4%), thrombocytopenia (4%), anemia (4%), and leukopenia (12%). Pathologically negative margins were achieved in 94.1% of patients who underwent pancreatectomy. Pathological response according to Evans' classification was grade IIA in 10 patients (58.8%), IIB in 5 patients (29.4%), and IV in 2 patients (11.8%). Postoperative pancreatic fistulas were observed in four patients (23.5%), delayed gastric emptying in one patient (5.9%), and other operative morbidities in four patients (23.5%). The 1-, 2-, 5-, and 10-year overall survival rates were 73.9%, 60.9%, 60.9%, and 39.1%, respectively (median follow-up period, 80.3 months). Conclusions: NACRT is tolerable and beneficial for resectable/borderline resectable PDAC, even in the long-term.

Original languageEnglish
Article number145
JournalWorld Journal of Surgical Oncology
Volume17
Issue number1
DOIs
Publication statusPublished - 2019 Aug 16

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Mitomycin
Pancreatic Neoplasms
Fluorouracil
Cisplatin
Radiotherapy
Safety
Chemoradiotherapy
Adenocarcinoma
Anorexia
Pancreatic Fistula
Pancreatectomy
Cholangitis
Gastric Emptying
Leukopenia
Clinical Protocols
Neutropenia
Anemia
Survival Rate
Retrospective Studies
Morbidity

Keywords

  • Chemoradiotherapy
  • Follow-up studies
  • Neoadjuvant therapy
  • Pancreatic carcinoma

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

@article{5168f2e859b741268bc2b59187024918,
title = "Efficacy and safety of preoperative 5-fluorouracil, cisplatin, and mitomycin C in combination with radiotherapy in patients with resectable and borderline resectable pancreatic cancer: A long-term follow-up study",
abstract = "Background: We aimed to evaluate the efficacy and safety of 5-fluorouracil-based neoadjuvant chemoradiotherapy (NACRT) in patients with resectable/borderline resectable pancreatic ductal adenocarcinoma (PDAC). Methods: This retrospective study investigated the clinicopathological features and > 5-year survival of patients with T3/T4 PDAC who underwent NACRT at our institute between 2003 and 2012. Results: Seventeen resectable and eight borderline resectable patients were included. The protocol treatment completion and resection rates were 92.0{\%} and 68.0{\%}, respectively. Two patients failed to complete chemotherapy owing to cholangitis or anorexia. Common grade 3 toxicities included anorexia (12{\%}), neutropenia (4{\%}), thrombocytopenia (4{\%}), anemia (4{\%}), and leukopenia (12{\%}). Pathologically negative margins were achieved in 94.1{\%} of patients who underwent pancreatectomy. Pathological response according to Evans' classification was grade IIA in 10 patients (58.8{\%}), IIB in 5 patients (29.4{\%}), and IV in 2 patients (11.8{\%}). Postoperative pancreatic fistulas were observed in four patients (23.5{\%}), delayed gastric emptying in one patient (5.9{\%}), and other operative morbidities in four patients (23.5{\%}). The 1-, 2-, 5-, and 10-year overall survival rates were 73.9{\%}, 60.9{\%}, 60.9{\%}, and 39.1{\%}, respectively (median follow-up period, 80.3 months). Conclusions: NACRT is tolerable and beneficial for resectable/borderline resectable PDAC, even in the long-term.",
keywords = "Chemoradiotherapy, Follow-up studies, Neoadjuvant therapy, Pancreatic carcinoma",
author = "Yutaka Endo and Minoru Kitago and Koichi Aiura and Masahiro Shinoda and Hiroshi Yagi and Yuta Abe and Go Oshima and Shutaro Hori and Yutaka Nakano and Osamu Itano and Junichi Fukada and Yohei Masugi and Yuko Kitagawa",
year = "2019",
month = "8",
day = "16",
doi = "10.1186/s12957-019-1687-4",
language = "English",
volume = "17",
journal = "World Journal of Surgical Oncology",
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TY - JOUR

T1 - Efficacy and safety of preoperative 5-fluorouracil, cisplatin, and mitomycin C in combination with radiotherapy in patients with resectable and borderline resectable pancreatic cancer

T2 - A long-term follow-up study

AU - Endo, Yutaka

AU - Kitago, Minoru

AU - Aiura, Koichi

AU - Shinoda, Masahiro

AU - Yagi, Hiroshi

AU - Abe, Yuta

AU - Oshima, Go

AU - Hori, Shutaro

AU - Nakano, Yutaka

AU - Itano, Osamu

AU - Fukada, Junichi

AU - Masugi, Yohei

AU - Kitagawa, Yuko

PY - 2019/8/16

Y1 - 2019/8/16

N2 - Background: We aimed to evaluate the efficacy and safety of 5-fluorouracil-based neoadjuvant chemoradiotherapy (NACRT) in patients with resectable/borderline resectable pancreatic ductal adenocarcinoma (PDAC). Methods: This retrospective study investigated the clinicopathological features and > 5-year survival of patients with T3/T4 PDAC who underwent NACRT at our institute between 2003 and 2012. Results: Seventeen resectable and eight borderline resectable patients were included. The protocol treatment completion and resection rates were 92.0% and 68.0%, respectively. Two patients failed to complete chemotherapy owing to cholangitis or anorexia. Common grade 3 toxicities included anorexia (12%), neutropenia (4%), thrombocytopenia (4%), anemia (4%), and leukopenia (12%). Pathologically negative margins were achieved in 94.1% of patients who underwent pancreatectomy. Pathological response according to Evans' classification was grade IIA in 10 patients (58.8%), IIB in 5 patients (29.4%), and IV in 2 patients (11.8%). Postoperative pancreatic fistulas were observed in four patients (23.5%), delayed gastric emptying in one patient (5.9%), and other operative morbidities in four patients (23.5%). The 1-, 2-, 5-, and 10-year overall survival rates were 73.9%, 60.9%, 60.9%, and 39.1%, respectively (median follow-up period, 80.3 months). Conclusions: NACRT is tolerable and beneficial for resectable/borderline resectable PDAC, even in the long-term.

AB - Background: We aimed to evaluate the efficacy and safety of 5-fluorouracil-based neoadjuvant chemoradiotherapy (NACRT) in patients with resectable/borderline resectable pancreatic ductal adenocarcinoma (PDAC). Methods: This retrospective study investigated the clinicopathological features and > 5-year survival of patients with T3/T4 PDAC who underwent NACRT at our institute between 2003 and 2012. Results: Seventeen resectable and eight borderline resectable patients were included. The protocol treatment completion and resection rates were 92.0% and 68.0%, respectively. Two patients failed to complete chemotherapy owing to cholangitis or anorexia. Common grade 3 toxicities included anorexia (12%), neutropenia (4%), thrombocytopenia (4%), anemia (4%), and leukopenia (12%). Pathologically negative margins were achieved in 94.1% of patients who underwent pancreatectomy. Pathological response according to Evans' classification was grade IIA in 10 patients (58.8%), IIB in 5 patients (29.4%), and IV in 2 patients (11.8%). Postoperative pancreatic fistulas were observed in four patients (23.5%), delayed gastric emptying in one patient (5.9%), and other operative morbidities in four patients (23.5%). The 1-, 2-, 5-, and 10-year overall survival rates were 73.9%, 60.9%, 60.9%, and 39.1%, respectively (median follow-up period, 80.3 months). Conclusions: NACRT is tolerable and beneficial for resectable/borderline resectable PDAC, even in the long-term.

KW - Chemoradiotherapy

KW - Follow-up studies

KW - Neoadjuvant therapy

KW - Pancreatic carcinoma

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U2 - 10.1186/s12957-019-1687-4

DO - 10.1186/s12957-019-1687-4

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