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Titolo:
Preoperative chemoradiation for marginally resectable adenocarcinoma of the pancreas
Autore:
Mehta, VK; Fisher, G; Ford, JA; Poen, JC; Vierra, MA; Oberbelman, H; Niederhuber, J; Bastidas, JA;
Indirizzi:
Stanford Univ, Med Ctr, Dept Radiat Oncol, Stanford, CA 94305 USA StanfordUniv Stanford CA USA 94305 Radiat Oncol, Stanford, CA 94305 USA Stanford Univ, Med Ctr, Dept Med, Div Med Oncol, Stanford, CA 94305 USA Stanford Univ Stanford CA USA 94305 Div Med Oncol, Stanford, CA 94305 USA Stanford Univ, Med Ctr, Dept Surg, Div Surg Oncol, Stanford, CA 94305 USA Stanford Univ Stanford CA USA 94305 iv Surg Oncol, Stanford, CA 94305 USA Univ Wisconsin, Dept Surg, Madison, WI USA Univ Wisconsin Madison WI USAUniv Wisconsin, Dept Surg, Madison, WI USA
Titolo Testata:
JOURNAL OF GASTROINTESTINAL SURGERY
fascicolo: 1, volume: 5, anno: 2001,
pagine: 27 - 35
SICI:
1091-255X(200101/02)5:1<27:PCFMRA>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
RADIATION-THERAPY; CANCER; RESECTION; PANCREATICODUODENECTOMY; CARCINOMA; HEAD; CHEMOTHERAPY; RADIOTHERAPY; EXPERIENCE; SURVIVAL;
Keywords:
pancreas; adenocarcinoma; preoperative; chemotherapy; radiation therapy; chemoradiation; neoadjuvant;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Mehta, VK Stanford Univ, Med Ctr, Dept Radiat Oncol, Stanford, CA 94305 USA Stanford Univ Stanford CA USA 94305 col, Stanford, CA 94305 USA
Citazione:
V.K. Mehta et al., "Preoperative chemoradiation for marginally resectable adenocarcinoma of the pancreas", J GASTRO S, 5(1), 2001, pp. 27-35

Abstract

Only 10% to 20% of patients with pancreatic cancer are considered candidates for curative resection at tile time of diagnosis. We postulated that preoperative chemoradiation therapy might promote turner regression, eradicatenodal metastases, and allow for definitive surgical resection in marginally resectable patients. Tile objective of this study was to evaluate the effect of a preoperative chemoradiation therapy regimen on tumor response , resectability, and local control among patients with marginally resectable adenocarcinoma of the pancreas and to report potential treatment-related toxicity Patients with marginally resectable adenocarcinoma of tile pancreas (defined as portal vein, superior mesenteric vein, or artery involvement) were eligible for this protocol. Patients received 50.4 to 56 Gy in 1.8 to 2.0Gy/day fractions with concurrent protracted venous infusion of 5-fluorouracil (250 mg/m(2)/day). Reevaluation for surgical resection occurred 4 to 6 weeks after therapy. Fifteen patients (9 men and 6 women) completed preoperative chemoradiation without interruption. One patient required a reductionin the dosage of 5-fluorouracil because of stomatitis. Acute toxicity fromchemoradiation consisted of grade 1 or 2 nausea, vomiting, diarrhea, stomatitis, palmar and plantar crythrodysesthesia, and hematologic suppression. Ch 19-9 levels declined in all nine of the patients with elevated pretreatment levels. Nine of the 15 patient underwent a pancreaticoduodenectomy, andall had uninvolved surgical margins. Two of these patients had a complete pathologic response, and two had microscopic involvement of a single lymph node. With a median follow-up of 30 months, tile median survival for resected patients was 30 months, whereas in the unresected group median survival n as 8 months. Sh of the nine patients who underwent resection remain aliveand disease free with follow-up of 30, 30, 34, 39, and 72 months, respectively. Preoperative chemoradiation therapy is well tolerated. It may downstage tumors, sterilize regional lymph nodes, and improve resectability in patients with marginally resectable pancreatic cancer. Greater patient accrualand longer follow-up are needed to more accurately assess its future role in therapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 00:25:54