Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Tinkl, D; Grabenbauer, GG; Golcher, H; Meyer, T; Papadopoulos, T; Hohenberger, W; Sauer, R; Brunner, TB.
Downstaging of pancreatic carcinoma after neoadjuvant chemoradiation.
Strahlenther Onkol. 2009; 185(9):557-66
Doi: 10.1007/s00066-009-1977-9
Web of Science
PubMed
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- Leading authors Med Uni Graz
- Brunner Thomas Baptist
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- Abstract:
- BACKGROUND AND PURPOSE: Neoadjuvant chemoradiation could improve survival in patients with pancreatic cancer because of a higher rate of R0 resections, lower rate of nodal metastasis (ypN) and of local recurrence. This approach was tested in a cohort to estimate its effect on survival. PATIENTS AND METHODS: Three-dimensional, conformal radiation to the primary tumor (55.8 Gy) and the lymphatics (50.4 Gy) was combined with chemotherapy. Resection was performed 6 weeks after completion of chemoradiation. RESULTS: 38 of 120 patients with locally advanced cancer underwent tumor resection thereafter. Three patients (8%) had pathologic complete response. Median tumor-specific survival was 29 months and overall survival 25 months. Patients with clear margins (35/38; 89%) had a 3-year disease-specific survival rate of 51% versus 0% with positive margins (p = 0.008). Nodal disease rate decreased from 50% at pretherapeutic imaging to 32% at resection. Patients with ypN0 status (n = 26/38) had a 3-year tumor-specific survival rate of 50% compared to 31% in patients with ypN1 status. At multivariate analysis, resection status and nodal spread significantly predicted tumor-specific survival. Chemoradiation was generally well tolerated. CONCLUSION: The current results support randomized testing of neoadjuvant chemoradiation to prove survival prolongation. Compared to the literature this approach seems to reduce the number of positive nodes.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult - administration & dosage
- Aged - administration & dosage
- Female - administration & dosage
- Follow-Up Studies - administration & dosage
- Humans - administration & dosage
- Male - administration & dosage
- Middle Aged - administration & dosage
- Multivariate Analysis - administration & dosage
- Neoadjuvant Therapy - adverse effects, methods
- Neoplasm Staging - administration & dosage
- Pancreatic Neoplasms - drug therapy, mortality, pathology, radiotherapy
- Survival Analysis - administration & dosage
- Time Factors - administration & dosage
- Find related publications in this database (Keywords)
- Pancreatic cancer
- Chemoradiotherapy
- Neoadjuvant
- Nodal status
- Prognosis