The Efficacy of Neoadjuvant Chemoradiation Therapy for Borderline Resectable Pancreatic Cancer

Toru Sano, Kiminori Takano, Naokazu Chiba, Koichi Tomita, Yosuke Ozawa, Kosuke Hikita, Motohide Shimazu, Shigeyuki Kawachi

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Surgical outcomes for locally advanced pancreatic cancer with severe vascular invasion are generally poor. The aim of this study was to evaluate whether neoadjuvant chemoradiation therapy (NACRT) could improve the survival of patients with locally advanced pancreatic cancer without distant metastasis.

METHODS: Between 2010 and 2014, a total of 20 consecutive patients with locally advanced pancreatic cancer without distant metastasis were treated with NACRT. These patients included borderline resectable (BR) and unresectable (UR) pancreatic cancer patients according to the NCCN guidelines. All patients were treated with 2 courses of low-dose gemcitabine plus S-1 combination (GS) chemotherapy and 50.4 Gy of radiation therapy. Restaging was performed 4-6 weeks after completion of NACRT, and curative resection was performed if local control was achieved and distant metastasis was absent.

RESULTS: Of the 20 patients, 7 (35.0%) underwent curative resection after NACRT. R0 resections were achieved in 6 patients (85.6%), and R1 resection was achieved in only 1 patient. Curative operation could not be performed in 13 patients (65.0%), because 3 patients refused surgery, 3 patients were diagnosed with dissemination on probe laparotomy or laparoscopy, and 7 patients had progressive disease with liver metastasis or dissemination on CT or MRI. Patients with a curative operation had a median disease-free survival (DFS) of 16.3 months and a median overall survival (OS) of 25.2 months. All of the patients without curative operation were treated with full-dose GS chemotherapy after NACRT. These patients had a median OS of 11.3 months.

CONCLUSION: Our strategy for treating BR or UR pancreatic cancer patients seems to be effective and there might be survival benefits if curative operations can be performed after NACRT.

Original languageEnglish
Pages (from-to)1488-1490
Number of pages3
JournalGan to kagaku ryoho. Cancer & chemotherapy
Volume42
Issue number12
Publication statusPublished - 2015 Nov 1
Externally publishedYes

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Neoadjuvant Therapy
Pancreatic Neoplasms
Neoplasm Metastasis
Survival
gemcitabine
Radiation Dosage
Combination Drug Therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Sano, T., Takano, K., Chiba, N., Tomita, K., Ozawa, Y., Hikita, K., ... Kawachi, S. (2015). The Efficacy of Neoadjuvant Chemoradiation Therapy for Borderline Resectable Pancreatic Cancer. Gan to kagaku ryoho. Cancer & chemotherapy, 42(12), 1488-1490.

The Efficacy of Neoadjuvant Chemoradiation Therapy for Borderline Resectable Pancreatic Cancer. / Sano, Toru; Takano, Kiminori; Chiba, Naokazu; Tomita, Koichi; Ozawa, Yosuke; Hikita, Kosuke; Shimazu, Motohide; Kawachi, Shigeyuki.

In: Gan to kagaku ryoho. Cancer & chemotherapy, Vol. 42, No. 12, 01.11.2015, p. 1488-1490.

Research output: Contribution to journalArticle

Sano, T, Takano, K, Chiba, N, Tomita, K, Ozawa, Y, Hikita, K, Shimazu, M & Kawachi, S 2015, 'The Efficacy of Neoadjuvant Chemoradiation Therapy for Borderline Resectable Pancreatic Cancer', Gan to kagaku ryoho. Cancer & chemotherapy, vol. 42, no. 12, pp. 1488-1490.
Sano T, Takano K, Chiba N, Tomita K, Ozawa Y, Hikita K et al. The Efficacy of Neoadjuvant Chemoradiation Therapy for Borderline Resectable Pancreatic Cancer. Gan to kagaku ryoho. Cancer & chemotherapy. 2015 Nov 1;42(12):1488-1490.
Sano, Toru ; Takano, Kiminori ; Chiba, Naokazu ; Tomita, Koichi ; Ozawa, Yosuke ; Hikita, Kosuke ; Shimazu, Motohide ; Kawachi, Shigeyuki. / The Efficacy of Neoadjuvant Chemoradiation Therapy for Borderline Resectable Pancreatic Cancer. In: Gan to kagaku ryoho. Cancer & chemotherapy. 2015 ; Vol. 42, No. 12. pp. 1488-1490.
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AU - Hikita, Kosuke

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N2 - INTRODUCTION: Surgical outcomes for locally advanced pancreatic cancer with severe vascular invasion are generally poor. The aim of this study was to evaluate whether neoadjuvant chemoradiation therapy (NACRT) could improve the survival of patients with locally advanced pancreatic cancer without distant metastasis.METHODS: Between 2010 and 2014, a total of 20 consecutive patients with locally advanced pancreatic cancer without distant metastasis were treated with NACRT. These patients included borderline resectable (BR) and unresectable (UR) pancreatic cancer patients according to the NCCN guidelines. All patients were treated with 2 courses of low-dose gemcitabine plus S-1 combination (GS) chemotherapy and 50.4 Gy of radiation therapy. Restaging was performed 4-6 weeks after completion of NACRT, and curative resection was performed if local control was achieved and distant metastasis was absent.RESULTS: Of the 20 patients, 7 (35.0%) underwent curative resection after NACRT. R0 resections were achieved in 6 patients (85.6%), and R1 resection was achieved in only 1 patient. Curative operation could not be performed in 13 patients (65.0%), because 3 patients refused surgery, 3 patients were diagnosed with dissemination on probe laparotomy or laparoscopy, and 7 patients had progressive disease with liver metastasis or dissemination on CT or MRI. Patients with a curative operation had a median disease-free survival (DFS) of 16.3 months and a median overall survival (OS) of 25.2 months. All of the patients without curative operation were treated with full-dose GS chemotherapy after NACRT. These patients had a median OS of 11.3 months.CONCLUSION: Our strategy for treating BR or UR pancreatic cancer patients seems to be effective and there might be survival benefits if curative operations can be performed after NACRT.

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