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Lack of effectiveness of radiotherapy combined with cisplatin in patients with locally advanced pancreatic carcinoma
Author(s) -
Okusaka Takuji,
Okada Shuichi,
Tokuuye Koichi,
Wakasugi Hideyuki,
Saisho Hiromitsu,
Ishikawa Osamu,
Matsuno Seiki,
Sato Tosiya,
Sato Keiko
Publication year - 2001
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(20010401)91:7<1384::aid-cncr1142>3.0.co;2-4
Subject(s) - medicine , leukocytopenia , chemoradiotherapy , radiation therapy , cisplatin , external beam radiotherapy , carcinoma , nausea , toxicity , surgery , fluorouracil , oncology , chemotherapy , brachytherapy
Abstract BACKGROUND Cisplatin has been reported to enhance the cell‐killing effect of radiation. The current study was conducted to evaluate the efficacy and toxicity of radiotherapy combined with cisplatin in patients with locally advanced pancreatic carcinoma. METHODS Forty‐one patients with pancreatic carcinoma that was unresectable but confined to the pancreatic region were treated with external beam radiation (50.4 grays [Gy] in 28 fractions over 5.5 weeks) and daily cisplatin (5 mg/m 2 /day as a 30‐minute infusion just before each radiation fraction). Maintenance 5‐fluorouracil (5‐FU) (500 mg/m 2 ) given once weekly was initiated 1 week after the completion of the chemoradiotherapy and continued until disease progression or unacceptable toxicity. RESULTS Of the 41 patients, 31 (76%) completed the scheduled course of chemoradiotherapy. The median survival time was 7.7 months, and the 1‐year survival rate was 36%. The median progression free survival time was 5.8 months. The first site of failure was distant metastases in 25 patients, locoregional recurrence in 6 patients, and both sites in 1 patient. The major toxicity was leukocytopenia and nausea/emesis. CONCLUSIONS Radiotherapy with daily cisplatin appears to be inferior to conventional chemoradiotherapy using 5‐FU in patients with locally advanced pancreatic carcinoma. Cancer 2001;91:1384–9. © 2001 American Cancer Society.