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The Results of Radiotherapy in Locally Advanced, Unresectable Pancreatic Cancer / 대한방사선종양학회지
The Journal of the Korean Society for Therapeutic Radiology and Oncology ; : 145-152, 2009.
Article in Korean | WPRIM | ID: wpr-35649
ABSTRACT

PURPOSE:

We retrospectively studied the outcomes and prognostic factors of patients with locally advanced, unresectable pancreatic cancer who were treated with concurrent chemoradiotherapy (CCRT) or radiotherapy only. MATERIALS AND

METHODS:

Fifty-one patients with locally advanced, unresectable pancreatic cancer (stage IIA~III) who recevied radiotherapy (> or =30 Gy) between January 1994 and August 2008 were reviewed retrospectively. The median radiation dose was 39 Gy. Chemotherapy consisted of gemcitabine, cisplatin, or 5-FU alone or in various combinations, and was administered concurrently with radiotherapy in 38 patients.

RESULTS:

The follow-up period ranged from 2~40 months (median, 8 months). The median survival, and the 1- and 2-year overall survival (OS) rates were 7 months, 15.7%, and 5.9%, respectively. Based on univariate analysis, the baseline CA19-9, performance status, and chemotherapy regimen were significant prognostic factors. The median survival was 8 months for CCRT, and 6 months for radiotherapy alone. The patients treated with gemcitabine-containing regimens had longer survival (median, 10 months) than the patients treated with radiotherapy alone (p=0.027). Twenty-three patients were available to evaluate the patterns of failure. Distant metastases (DM) occured in 18 patients and regional recurrences were demonstrated in 4 patients. Local progression developed in 14 patients. We analyzed the association between the time-to-DM and the baseline CA19-9 levels for 18 evaluable patients. The median time-to-DM was 20 months for patients with normal baseline CA19-9 levels and 2 months for patients with baseline CA19-9 levels > or =200 U/ml.

CONCLUSION:

CCRT with gemcitabine-based regimens was effective in improving OS in patients with locally advanced, unresectable pancreatic cancer. We suggest that the baseline CA19-9 level is valuable in determining the treatment strategy for patients with locally advanced, unresectable pancreatic cancer.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Pancreatic Neoplasms / Recurrence / Retrospective Studies / Follow-Up Studies / Cisplatin / Deoxycytidine / Chemoradiotherapy / Fluorouracil / Neoplasm Metastasis Type of study: Observational study / Prognostic study / Risk factors Limits: Humans Language: Korean Journal: The Journal of the Korean Society for Therapeutic Radiology and Oncology Year: 2009 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Pancreatic Neoplasms / Recurrence / Retrospective Studies / Follow-Up Studies / Cisplatin / Deoxycytidine / Chemoradiotherapy / Fluorouracil / Neoplasm Metastasis Type of study: Observational study / Prognostic study / Risk factors Limits: Humans Language: Korean Journal: The Journal of the Korean Society for Therapeutic Radiology and Oncology Year: 2009 Type: Article