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PurposeDespite curative resection, the 5-year survival for patients with resectable pancreatic cancer is less than 20%. Recurrence occurs both locally and at distant sites and effective multimodality adjuvant treatment is needed.Materials and MethodsPatients with curatively resected stage IB-IIB pancreatic adenocarcinoma were eligible. Treatment consisted of chemotherapy with gemcitabine 1,000mg/m2 on days 1 and 8 and cisplatin 60mg/m2 on day 1 every 3 weeks for 2 cycles, followed by chemoradiotherapy (50.4Gy/28Fx's) with weekly gemcitabine (300mg/m2/week), and then gemcitabine 1,000mg/m2 on day 1, 8 every 3 weeks for 4 cycles. The primary endpoint was one-year disease-free survival rate. The secondary endpoints were disease-free survival, overall survival, and safety.ResultsSeventy-four patients were enrolled. One-year disease-free survival rate was 57.9%. Median disease-free and overall survival were 15.0 months (95% confidence interval [CI], 11.6-18.4) and 33.0 months (95% CI, 21.8-44.2), respectively. At the median follow up of 32 months, 57 patients (77.0%) had recurrence including 11 patients whose recurrence was during the adjuvant treatment. Most of the recurrences were systemic (52 patients). Stage at the time of diagnosis (70.0% in IIA, 51.2% in IIB, p=0.006) were significantly related with 1-year DFS rate. Toxicities were generally tolerable, with 53 events of grade 3 or 4 hematologic toxicity and four patients with febrile neutropenia.ConclusionAdjuvant gemcitabine and cisplatin chemotherapy followed by chemoradiotherapy with gemcitabine and maintenance gemcitabine showed efficacy and good tolerability in curatively resected pancreatic cancer.

cancer research and treatment/cancer research and treatment

Phase II Trial of Postoperative Adjuvant Gemcitabine and Cisplatin Chemotherapy Followed by Chemoradiotherapy with Gemcitabine in Patients with Resected Pancreatic Cancer