Treatment of unresectable, locally advanced pancreatic adenocarcinoma with combined radiochemotherapy with 5-fluorouracil, leucovorin and cisplatin

G. V. Kornek, A. Schratter-Sehn, A. Marczell, D. Depisch, J. Karner, G. Krauss, K. Haider, W. Kwasny, G. Locker, W. Scheithauer

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Abstract

The aim of the study was to evaluate the effectiveness and safety of a combined treatment modality including systemic chemotherapy with 5-fluorouracil (FU), leucovorin, cisplatin and external beam radiotherapy in patients with locally advanced pancreatic cancer. Systemic chemotherapy consisted of FU 400 mg m-2 and leucovorin 20 mg m-2 both given as intravenous bolus injection on days 1-4, plus cisplatin 20 mg m-2 administered as 90-min infusion on days 1-4. Treatment courses were repeated every 4 weeks x 6 unless prior evidence of progressive disease. Radiation therapy using megavolt irradiation of ≥ 6 MV photons with a 3- or 4-field technique was delivered during the second and third chemotherapy course, that was reduced in dose by 25%. Between October 1994 and July 1996, a total of 38 patients were entered onto this trial, all of whom were assessable for toxicity and survival. Eighteen of these (47%) had objective remissions to combined radiochemotherapy, including four CR (11%), 13 (34%) had stable disease and seven patients (18%) showed tumour progression during treatment. The median progression-free interval of the entire study population was 10 months (range 3-32), and median overall survival was 14.0 months (range 3-45+ months); 53% of all patients were alive at 12 months, and 18% of patients were alive at 24 months respectively. Severe haematological side-effects comprised neutropenia in 18%, thrombocytopenia in 8% and anaemia in 11%. The most frequent non-haematological side-effects were nausea/vomiting (WHO grade 3: 18%), and diarrhoea (grade 3: 13%). This combined radiochemotherapy regimen was tolerable and effective in patients with locally advanced pancreatic cancer. Since therapeutic results, in fact, compare favourably with other series, including surgical treatment of potentially resectable tumours, further evaluation of combined treatment modalities in the neoadjuvant setting seems warranted.

Original languageEnglish
Pages (from-to)98-103
Number of pages6
JournalBritish Journal of Cancer
Volume82
Issue number1
Publication statusPublished - 2000

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Leucovorin
Chemoradiotherapy
Fluorouracil
Cisplatin
Adenocarcinoma
Pancreatic Neoplasms
Drug Therapy
Radiotherapy
Therapeutics
Survival
Neutropenia
Photons
Intravenous Injections
Thrombocytopenia
Nausea
Vomiting
Anemia
Diarrhea
Neoplasms
Safety

Keywords

  • 5-Fluorouracil, leucovorin
  • Chemoradiation
  • Cisplatin
  • Neoadjuvant
  • Pancreatic cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Treatment of unresectable, locally advanced pancreatic adenocarcinoma with combined radiochemotherapy with 5-fluorouracil, leucovorin and cisplatin. / Kornek, G. V.; Schratter-Sehn, A.; Marczell, A.; Depisch, D.; Karner, J.; Krauss, G.; Haider, K.; Kwasny, W.; Locker, G.; Scheithauer, W.

In: British Journal of Cancer, Vol. 82, No. 1, 2000, p. 98-103.

Research output: Contribution to journalArticle

Kornek, GV, Schratter-Sehn, A, Marczell, A, Depisch, D, Karner, J, Krauss, G, Haider, K, Kwasny, W, Locker, G & Scheithauer, W 2000, 'Treatment of unresectable, locally advanced pancreatic adenocarcinoma with combined radiochemotherapy with 5-fluorouracil, leucovorin and cisplatin', British Journal of Cancer, vol. 82, no. 1, pp. 98-103.
Kornek, G. V. ; Schratter-Sehn, A. ; Marczell, A. ; Depisch, D. ; Karner, J. ; Krauss, G. ; Haider, K. ; Kwasny, W. ; Locker, G. ; Scheithauer, W. / Treatment of unresectable, locally advanced pancreatic adenocarcinoma with combined radiochemotherapy with 5-fluorouracil, leucovorin and cisplatin. In: British Journal of Cancer. 2000 ; Vol. 82, No. 1. pp. 98-103.
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abstract = "The aim of the study was to evaluate the effectiveness and safety of a combined treatment modality including systemic chemotherapy with 5-fluorouracil (FU), leucovorin, cisplatin and external beam radiotherapy in patients with locally advanced pancreatic cancer. Systemic chemotherapy consisted of FU 400 mg m-2 and leucovorin 20 mg m-2 both given as intravenous bolus injection on days 1-4, plus cisplatin 20 mg m-2 administered as 90-min infusion on days 1-4. Treatment courses were repeated every 4 weeks x 6 unless prior evidence of progressive disease. Radiation therapy using megavolt irradiation of ≥ 6 MV photons with a 3- or 4-field technique was delivered during the second and third chemotherapy course, that was reduced in dose by 25{\%}. Between October 1994 and July 1996, a total of 38 patients were entered onto this trial, all of whom were assessable for toxicity and survival. Eighteen of these (47{\%}) had objective remissions to combined radiochemotherapy, including four CR (11{\%}), 13 (34{\%}) had stable disease and seven patients (18{\%}) showed tumour progression during treatment. The median progression-free interval of the entire study population was 10 months (range 3-32), and median overall survival was 14.0 months (range 3-45+ months); 53{\%} of all patients were alive at 12 months, and 18{\%} of patients were alive at 24 months respectively. Severe haematological side-effects comprised neutropenia in 18{\%}, thrombocytopenia in 8{\%} and anaemia in 11{\%}. The most frequent non-haematological side-effects were nausea/vomiting (WHO grade 3: 18{\%}), and diarrhoea (grade 3: 13{\%}). This combined radiochemotherapy regimen was tolerable and effective in patients with locally advanced pancreatic cancer. Since therapeutic results, in fact, compare favourably with other series, including surgical treatment of potentially resectable tumours, further evaluation of combined treatment modalities in the neoadjuvant setting seems warranted.",
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AU - Karner, J.

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