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Kastl, S; Brunner, T; Herrmann, O; Riepl, M; Fietkau, R; Grabenbauer, G; Sauer, R; Hohenberger, W; Klein, P.
Neoadjuvant radio-chemotherapy in advanced primarilynon-resectable carcinomas of the pancreas.
Eur J Surg Oncol. 2000; 26(6):578-82 Doi: 10.1053/ejso.2000.0950
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Co-authors Med Uni Graz: Brunner Thomas Baptist
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Abstract:: AIM: To investigate the feasibility of neoadjuvant radio-chemotherapy (RCT) in the treatment of primarily non-resectable pancreas carcinoma the parameters tumour regression, possibility of subsequent resection and tolerability were examined. METHOD: Between 1995 and 1997, 27 patients with locally inoperable (assessed by CT criteria) pancreatic carcinoma received radio-chemotherapy for 5 weeks comprising irradiation (55.8 Gy) and chemotherapy with 5-fluorouracil (5-FU, 1000 mg/m(2)/day; 120 h continuous infusion) and mitomycin C (10 mg/m(2)i.v.-bolus, day 2 and day 30) during the first and fifth week of radiotherapy. Two target volumes were irradiated with fractionated doses of 1.8 Gy up to a total of 50.4 Gy. Radiation was applied once a day five times a week and target volume 1 was irradiated with the same fractionated dose, and an additional boost of 5.4 Gy to make an overall total of 55.8 Gy. RESULTS: Sixteen patients underwent explorative laparotomy, 10 of these were resected (eight Whipple's procedures, two distal pancreatic resections), while six could not be resected due to peritoneal carcinosis (n=3), local irresectability (n=2) and liver cirrhosis (n=1). A further nine patients were found to have unresectable tumours on CT and did not undergo surgery after restaging (five of these patients were staged as <>, three patients had distant metastases and one patient refused surgery). In two patients RCT was abandoned because of progression of disease. CONCLUSIONS: The study protocol described is feasible without significant acute toxicity and when used the resectability rate was improved; the survival rate, however, was not improved. Additional intra-arterial or intraportal application of such drugs as mitomycin C or cisplatin may be necessary.
Find related publications in this database (using NLM MeSH Indexing): Adenocarcinoma - drug therapy, radiotherapy, surgery, therapy; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Dose Fractionation, Radiation - administration & dosage; Fluorouracil - administration & dosage; Humans - administration & dosage; Mitomycin - administration & dosage; Neoadjuvant Therapy - administration & dosage; Pancreatic Neoplasms - drug therapy, radiotherapy, surgery, therapy; Pilot Projects - administration & dosage; Prospective Studies - administration & dosage
Find related publications in this database (Keywords): pancreatic cancer; multimodal therapy; radio-chemotherapy; resection rate