Concurrent gemcitabine and radiotherapy with and without neoadjuvant gemcitabine for locally advanced unresectable or resected pancreatic cancer: A phase I-II study

Journal Article · Thu Mar 15 04:00:00 EDT 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.10.015· OSTI ID:20944759

Brade, Anthony ^[1]; Brierley, James ^[1]; Oza, Amit ^[2]; Gallinger, Steven ^[3]; Cummings, Bernard ^[1]; MacLean, Martha ^[2]; Pond, Gregory R ^[4]; Hedley, David ^[2]; Shun, Wong ^[5]; Townsley, Carol ^[2]; Brezden-Masley, Christine ^[6]; Moore, Malcolm ^[2]

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1. Department of Radiation Oncology, University Health Network Princess Margaret Hospital, Toronto, Ontario (Canada)
2. Department of Medical Oncology, University Health Network Princess Margaret Hospital, Toronto, Ontario (Canada)
3. Department of Surgical Oncology, University Health Network Princess Margaret Hospital, Toronto, Ontario (Canada)
4. Department of Biostatistics, University Health Network Princess Margaret Hospital, Toronto, Ontario (Canada)
5. Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada)
6. Department of Medical Oncology, St. Michael's Hospital, University of Toronto Faculty of Medicine, Toronto, Ontario (Canada)

Purpose: To determine the safety, efficacy, and tolerability of biweekly gemcitabine with concurrent radiotherapy (RT) for resected and locally advanced (LA) pancreatic cancer. Methods and Materials: Eligible patients had either LA or resected pancreatic cancer. Between March 1999 and July 2001, 63 patients (31 with LA and 32 with resected disease) were treated. Of the 63 patients, 28 were enrolled in a Phase I study of increasing radiation doses (35 Gy [n = 7], 43.75 Gy [n = 11], and 52.5 Gy [n = 10] given within 4, 5, or 6 weeks, respectively, in 1.75-Gy fractions) concurrently with 40 mg/m{sup 2} gemcitabine biweekly. Subsequently, 35 were enrolled in a Phase II study with the addition of induction gemcitabine 1000 mg/m{sup 2} within 7 or 8 weeks to concurrent biweekly gemcitabine (40 mg/m{sup 2}) and 52.5 Gy RT within 6 weeks. Results: In the LA population, the best response observed was a complete response in 1, partial response in 3, stable disease in 10, and progressive disease in 17. In the phase II trial, gemcitabine plus RT was not delivered to 8 patients because of progression with induction gemcitabine alone (n = 5) or by patient request (n = 3). On intent-to-treat analysis, the median survival in the LA patients was 13.9 months and the 2-year survival rate was 16.1%. In the resected population, the median progression-free survival was 8.3 months, the median survival was 18.4 months, and the 2- and 5-year survival rate was 36% and 19.4%, respectively. The treatment was well tolerated; the median gemcitabine dose intensity was 96% of the planned dose in the neoadjuvant and concurrent portions of the Phase II study. No treatment-related deaths occurred. Conclusion: Biweekly gemcitabine (40 mg/m{sup 2}) concurrently with RT (52.5 Gy in 30 fractions of 1.75 Gy) with or without induction gemcitabine is safe and tolerable and shows efficacy in patients with LA and resected pancreatic cancer.

• OSTI ID: 20944759
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 67; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
DEATH
PANCREAS
PATIENTS
RADIATION DOSES
RADIOTHERAPY
SAFETY