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Title: Capecitabine and radiation therapy preceded and followed by combination chemotherapy in advanced pancreatic cancer

Abstract

Purpose: The primary objective of this study was to evaluate the tolerance and toxicity of radiation therapy (RT) and capecitabine in patients with advanced, unresectable pancreatic carcinoma. To control micrometastatic disease, combination chemotherapy (gemcitabine and cisplatin) before and after combined modality therapy (CMT) was planned. Methods and Materials: Patients with unresectable or metastatic pancreatic cancer were eligible. Gemcitabine 1000 mg/m{sup 2} and cisplatin 35 mg/m{sup 2} were administered on Days 1 and 8 of a 21-day cycle for two cycles. RT was then given to a dose of 50.4 Gy in 1.8 Gy fractions. Patients were treated with capecitabine 1330 mg/m{sup 2} daily during RT. After CMT, two additional cycles of gemcitabine and cisplatin completed the treatment. Results: Twenty-three patients were treated. Eighteen patients completed CMT. One patient was removed from study during CMT for toxicity issues. Treatment delays and dose reductions were common during the final two cycles of gemcitabine and cisplatin as a result of myelosuppression. Median survival was 10.1 months (95% confidence interval [CI] = 7.6, 13.7) for all 23 patients and 12.8 months (95% CI = 8.2, 18.9) for 18 patients without metastasis. Conclusion: Combined modality therapy with RT and capecitabine was well tolerated. Chemotherapy aftermore » CMT was difficult to complete owing to cumulative myelosuppression. Survival, response, and toxicity were comparable to infusional 5-fluorouracil and RT.« less

Authors:
 [1];  [2];  [2];  [3];  [3];  [2];  [4];  [1];  [2];  [5]
  1. Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, MI (United States)
  2. Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, MI (United States)
  3. Department of Surgery, University of Michigan Medical Center, Ann Arbor, MI (United States)
  4. (United States)
  5. Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, MI (United States). E-mail: Zalupski@umich.edu
Publication Date:
OSTI Identifier:
20788222
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 63; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2005.04.030; PII: S0360-3016(05)00758-3; Copyright (c) 2005 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; METASTASES; PANCREAS; PATIENTS; RADIOTHERAPY; TOXICITY; URACILS

Citation Formats

Schneider, Bryan J., Ben-Josef, Edgar, McGinn, Cornelius J., Chang, Alfred E., Colletti, Lisa M., Normolle, Daniel P., Comprehensive Cancer Center Biostatistics Unit, University of Michigan Medical Center, Ann Arbor, MI, Hejna, Gwen F. P.A., Lawrence, Theodore S., and Zalupski, Mark M.. Capecitabine and radiation therapy preceded and followed by combination chemotherapy in advanced pancreatic cancer. United States: N. p., 2005. Web. doi:10.1016/J.IJROBP.2005.0.
Schneider, Bryan J., Ben-Josef, Edgar, McGinn, Cornelius J., Chang, Alfred E., Colletti, Lisa M., Normolle, Daniel P., Comprehensive Cancer Center Biostatistics Unit, University of Michigan Medical Center, Ann Arbor, MI, Hejna, Gwen F. P.A., Lawrence, Theodore S., & Zalupski, Mark M.. Capecitabine and radiation therapy preceded and followed by combination chemotherapy in advanced pancreatic cancer. United States. doi:10.1016/J.IJROBP.2005.0.
Schneider, Bryan J., Ben-Josef, Edgar, McGinn, Cornelius J., Chang, Alfred E., Colletti, Lisa M., Normolle, Daniel P., Comprehensive Cancer Center Biostatistics Unit, University of Michigan Medical Center, Ann Arbor, MI, Hejna, Gwen F. P.A., Lawrence, Theodore S., and Zalupski, Mark M.. Thu . "Capecitabine and radiation therapy preceded and followed by combination chemotherapy in advanced pancreatic cancer". United States. doi:10.1016/J.IJROBP.2005.0.
@article{osti_20788222,
title = {Capecitabine and radiation therapy preceded and followed by combination chemotherapy in advanced pancreatic cancer},
author = {Schneider, Bryan J. and Ben-Josef, Edgar and McGinn, Cornelius J. and Chang, Alfred E. and Colletti, Lisa M. and Normolle, Daniel P. and Comprehensive Cancer Center Biostatistics Unit, University of Michigan Medical Center, Ann Arbor, MI and Hejna, Gwen F. P.A. and Lawrence, Theodore S. and Zalupski, Mark M.},
abstractNote = {Purpose: The primary objective of this study was to evaluate the tolerance and toxicity of radiation therapy (RT) and capecitabine in patients with advanced, unresectable pancreatic carcinoma. To control micrometastatic disease, combination chemotherapy (gemcitabine and cisplatin) before and after combined modality therapy (CMT) was planned. Methods and Materials: Patients with unresectable or metastatic pancreatic cancer were eligible. Gemcitabine 1000 mg/m{sup 2} and cisplatin 35 mg/m{sup 2} were administered on Days 1 and 8 of a 21-day cycle for two cycles. RT was then given to a dose of 50.4 Gy in 1.8 Gy fractions. Patients were treated with capecitabine 1330 mg/m{sup 2} daily during RT. After CMT, two additional cycles of gemcitabine and cisplatin completed the treatment. Results: Twenty-three patients were treated. Eighteen patients completed CMT. One patient was removed from study during CMT for toxicity issues. Treatment delays and dose reductions were common during the final two cycles of gemcitabine and cisplatin as a result of myelosuppression. Median survival was 10.1 months (95% confidence interval [CI] = 7.6, 13.7) for all 23 patients and 12.8 months (95% CI = 8.2, 18.9) for 18 patients without metastasis. Conclusion: Combined modality therapy with RT and capecitabine was well tolerated. Chemotherapy after CMT was difficult to complete owing to cumulative myelosuppression. Survival, response, and toxicity were comparable to infusional 5-fluorouracil and RT.},
doi = {10.1016/J.IJROBP.2005.0},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 5,
volume = 63,
place = {United States},
year = {Thu Dec 01 00:00:00 EST 2005},
month = {Thu Dec 01 00:00:00 EST 2005}
}