5-FU and mitomycin-C in conjunction with radiotherapy in patients with locally advanced pancreatic carcinoma

ABSTRACT

To evaluate the outcome of concomitant radiocemotherapy [RCT] in terms of treatment response, tolerability, possibility of subsequent surgical resection and survival in locally advanced pancreatic carcinoma. Twenty patients with locally advanced pancreatic carcinoma had been included in a prospective study. Patients had attended to Kas El Aini Center of Clinical Oncology and to the Menoufiya University Hospital and Liver institute, between September 1998 and December 2000. All patients were treated by RCT compirising 5400 cGy daily fractions of180 cGy 5 days a week, 5-Floruracil [5-FU] 600mg/m2 by continuous intravenous infusion day 1-day 5 and Mitomycin-C' 10mg/m[2], i.v.-bolus day 2. Chemotherapy was repeated on day 29. patients were re-evaluated for the treatment outcome and the possibility of surgical resection 4 weeks after RCT Treatment response, toxicity and overall survival were the study end point. Twelve patients [60%] had decreased primary tumor size. Five cases appeared potentially respectable by CT and exp1plorative laparotomies were done but only four could be respected. The median survival of the study group was 10 months [range 4-21]. Themedian survival of patients who had undergone surgery was 19 ms [1421] response but appeared irresistible by the CT scan. The mediam survival of patients with stationary or progressive tumors was 6.5 ms [4-10]. The treatment applied in the study is feasible and have o significant acute toxicity. The respectability was improved but with no improvement of survival. Additional neoadjuvanl chemotherapy trials with new regimens may support the potential benefits of this line of treatmen