The Results of Radiotherapy in Locally Advanced, Unresectable Pancreatic Cancer.
10.3857/jkstro.2009.27.3.145
- Author:
Hyun Soo JANG
1
;
Seung Hee KANG
;
Sang Won KIM
;
Mison CHUN
;
Sun Mi JO
;
Jun Chul LIM
;
Young Taek OH
;
Seok Yun KANG
Author Information
1. Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea. shkang@ajou.ac.kr
- Publication Type:Original Article
- Keywords:
Pancreatic cancer;
Concurrent chemoradiotherapy;
Radiotherapy;
CA19-9
- MeSH:
Chemoradiotherapy;
Cisplatin;
Deoxycytidine;
Fluorouracil;
Follow-Up Studies;
Humans;
Neoplasm Metastasis;
Pancreatic Neoplasms;
Recurrence;
Retrospective Studies
- From:The Journal of the Korean Society for Therapeutic Radiology and Oncology
2009;27(3):145-152
- CountryRepublic of Korea
- Language:Korean
-
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.
