Radiochemotherapy combined with continuous infusional gemcitabine for locally advanced unresectable pancreatic adenocarcinoma / 重庆医科大学学报

ABSTRACT

Objective:To evaluate the curative efficacy,clinical benefit response (CBR),survival length and toxicity of radiochemotherapy combined with 24 hours continuous infusional gemcitabine for locally advanced unresectable pancreatic adenocarcinoma.Methods:20 patients with histologically or cytologically confirmed locally advanced unresectable pancreatic adenocarcinoma were enrolled into this trial,all of whom had bidimensionally measurable disease that could be assessed by radiographic procedures.Gemcitabine was administered as a 24 hours continuous infusion once weekly for 3 of 4 weeks.Radiation therapy was 3 dimensional conformal radiation therapy (3DCRT),using megavolt irradiation(total dose,45Gy,1.8/Gy/day) of 6MV photons or greater with a 3 or 4-field technique which was delivered concurrently for 5 weeks.Results:Only 2 partial response was observed(10%),and disease was stabilized in 13 additional patients(65%).The median time to progression was 6.5 months (range, 2～13 months).Although all patients developed distant metastases,locoregional failure occurred in only 4.The median survival time was 9.6months (range,3～23.0~+months),and 1-year survival rate was 14.3%.Positive CBR was 14/17(82.4%).The main side effects included slight liver function damage and neutropenia,thrombocytopenia,hypochromia.Conclusion:Gemcitabine when given as prolonged infusion in 130mg/m~2/week combined with 3DCRT is feasible and effective for local control of pancreatic cancer and CBR,but essentially ineffective in counteracting metastatic tumor growth.