Toxicities and effects of involved-field irradiation with concurrent cisplatin for unresectable carcinoma of the pancreas

Hiroyuki Kawakami, Takashi Uno, Kouichi Isobe, Naoyuki Ueno, Takashi Aruga, Kentaro Sudo, Taketo Yamaguchi, Hiromitsu Saisho, Tetsuya Kawata, Hisao Ito

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: To evaluate local effects and acute toxicities of involved field irradiation with concurrent cisplatin (CDDP) for unresectable pancreatic carcinoma. Materials and Methods: Thirty-three patients with unresectable pancreatic carcinoma were treated with chemoradiotherapy. Sixteen were Stage IVA; 17 were Stage IVB. The total prescribed dose of radiotherapy was 50 Gy/25 fractions or 50.4 Gy/28 fractions, using a three-dimensionally determined involved-field that included only the primary tumor and clinically enlarged lymph nodes. Twelve patients received a daily i.v. infusion of CDDP; 21 patients received a combination of CDDP and 5-fluorouracil either i.v. or through the proper hepatic artery. Results: Twenty-seven (82%) patients completed planned chemoradiotherapy. Nausea was the most frequent complaint. No patient experienced Grade 4 toxicities. More than half achieved pain relief. As for the primary site, only 4 patients (12%) achieved a partial response at 4 weeks; however, 3 additional patients attained >50% tumor reduction thereafter. The most frequent site of disease progression was the liver, and only 3 patients developed local progression alone. No regional lymph nodal progression outside the treatment field was seen. Median survival time and survival at 1 year were 7.1 months and 27%, respectively, for the entire group. Difference in overall survival between patients with and without distant metastases was significant (p = 0.01). Conclusions: Involved-field irradiation with concurrent daily CDDP was well tolerated without compromising locoregional effects.

Original languageEnglish
Pages (from-to)1357-1362
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume62
Issue number5
DOIs
Publication statusPublished - 2005 Aug 1
Externally publishedYes

Fingerprint

pancreas
toxicity
Cisplatin
Pancreas
cancer
Carcinoma
irradiation
progressions
Chemoradiotherapy
Survival
tumors
lymph
nausea
pain
lymphatic system
Hepatic Artery
metastasis
Lymph
arteries
liver

Keywords

  • Concurrent chemoradiation
  • Involved field
  • Pain
  • Pancreatic carcinoma
  • Radiation therapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Toxicities and effects of involved-field irradiation with concurrent cisplatin for unresectable carcinoma of the pancreas. / Kawakami, Hiroyuki; Uno, Takashi; Isobe, Kouichi; Ueno, Naoyuki; Aruga, Takashi; Sudo, Kentaro; Yamaguchi, Taketo; Saisho, Hiromitsu; Kawata, Tetsuya; Ito, Hisao.

In: International Journal of Radiation Oncology Biology Physics, Vol. 62, No. 5, 01.08.2005, p. 1357-1362.

Research output: Contribution to journalArticle

Kawakami, Hiroyuki ; Uno, Takashi ; Isobe, Kouichi ; Ueno, Naoyuki ; Aruga, Takashi ; Sudo, Kentaro ; Yamaguchi, Taketo ; Saisho, Hiromitsu ; Kawata, Tetsuya ; Ito, Hisao. / Toxicities and effects of involved-field irradiation with concurrent cisplatin for unresectable carcinoma of the pancreas. In: International Journal of Radiation Oncology Biology Physics. 2005 ; Vol. 62, No. 5. pp. 1357-1362.
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AU - Isobe, Kouichi

AU - Ueno, Naoyuki

AU - Aruga, Takashi

AU - Sudo, Kentaro

AU - Yamaguchi, Taketo

AU - Saisho, Hiromitsu

AU - Kawata, Tetsuya

AU - Ito, Hisao

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N2 - Purpose: To evaluate local effects and acute toxicities of involved field irradiation with concurrent cisplatin (CDDP) for unresectable pancreatic carcinoma. Materials and Methods: Thirty-three patients with unresectable pancreatic carcinoma were treated with chemoradiotherapy. Sixteen were Stage IVA; 17 were Stage IVB. The total prescribed dose of radiotherapy was 50 Gy/25 fractions or 50.4 Gy/28 fractions, using a three-dimensionally determined involved-field that included only the primary tumor and clinically enlarged lymph nodes. Twelve patients received a daily i.v. infusion of CDDP; 21 patients received a combination of CDDP and 5-fluorouracil either i.v. or through the proper hepatic artery. Results: Twenty-seven (82%) patients completed planned chemoradiotherapy. Nausea was the most frequent complaint. No patient experienced Grade 4 toxicities. More than half achieved pain relief. As for the primary site, only 4 patients (12%) achieved a partial response at 4 weeks; however, 3 additional patients attained >50% tumor reduction thereafter. The most frequent site of disease progression was the liver, and only 3 patients developed local progression alone. No regional lymph nodal progression outside the treatment field was seen. Median survival time and survival at 1 year were 7.1 months and 27%, respectively, for the entire group. Difference in overall survival between patients with and without distant metastases was significant (p = 0.01). Conclusions: Involved-field irradiation with concurrent daily CDDP was well tolerated without compromising locoregional effects.

AB - Purpose: To evaluate local effects and acute toxicities of involved field irradiation with concurrent cisplatin (CDDP) for unresectable pancreatic carcinoma. Materials and Methods: Thirty-three patients with unresectable pancreatic carcinoma were treated with chemoradiotherapy. Sixteen were Stage IVA; 17 were Stage IVB. The total prescribed dose of radiotherapy was 50 Gy/25 fractions or 50.4 Gy/28 fractions, using a three-dimensionally determined involved-field that included only the primary tumor and clinically enlarged lymph nodes. Twelve patients received a daily i.v. infusion of CDDP; 21 patients received a combination of CDDP and 5-fluorouracil either i.v. or through the proper hepatic artery. Results: Twenty-seven (82%) patients completed planned chemoradiotherapy. Nausea was the most frequent complaint. No patient experienced Grade 4 toxicities. More than half achieved pain relief. As for the primary site, only 4 patients (12%) achieved a partial response at 4 weeks; however, 3 additional patients attained >50% tumor reduction thereafter. The most frequent site of disease progression was the liver, and only 3 patients developed local progression alone. No regional lymph nodal progression outside the treatment field was seen. Median survival time and survival at 1 year were 7.1 months and 27%, respectively, for the entire group. Difference in overall survival between patients with and without distant metastases was significant (p = 0.01). Conclusions: Involved-field irradiation with concurrent daily CDDP was well tolerated without compromising locoregional effects.

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