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J Korean Soc Ther Radiol Oncol > Volume 27(3); 2009 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2009;27(3): 145-152. doi: https://doi.org/10.3857/jkstro.2009.27.3.145
The Results of Radiotherapy in Locally Advanced, Unresectable Pancreatic Cancer
Hyun Soo Jang, Seung Hee Kang, Sang Won Kim, Mison Chun, Sun Mi Jo, Jun Chul Lim, Young Taek Oh, Seok Yun Kang
1Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea. shkang@ajou.ac.kr
2Department of Medical Oncology, Ajou University School of Medicine, Suwon, Korea.
ABSTRACT
PURPOSE:
We retrospectively studied the outcomes and prognostic factors of patients with locally advanced, unresectable pancreatic cancer who were treated with concurrent chemoradiotherapy (CCRT) or radiotherapy only.
MATERIALS AND METHODS:
Fifty-one patients with locally advanced, unresectable pancreatic cancer (stage IIA~III) who recevied radiotherapy (> or =30 Gy) between January 1994 and August 2008 were reviewed retrospectively. The median radiation dose was 39 Gy. Chemotherapy consisted of gemcitabine, cisplatin, or 5-FU alone or in various combinations, and was administered concurrently with radiotherapy in 38 patients.
RESULTS:
The follow-up period ranged from 2~40 months (median, 8 months). The median survival, and the 1- and 2-year overall survival (OS) rates were 7 months, 15.7%, and 5.9%, respectively. Based on univariate analysis, the baseline CA19-9, performance status, and chemotherapy regimen were significant prognostic factors. The median survival was 8 months for CCRT, and 6 months for radiotherapy alone. The patients treated with gemcitabine-containing regimens had longer survival (median, 10 months) than the patients treated with radiotherapy alone (p=0.027). Twenty-three patients were available to evaluate the patterns of failure. Distant metastases (DM) occured in 18 patients and regional recurrences were demonstrated in 4 patients. Local progression developed in 14 patients. We analyzed the association between the time-to-DM and the baseline CA19-9 levels for 18 evaluable patients. The median time-to-DM was 20 months for patients with normal baseline CA19-9 levels and 2 months for patients with baseline CA19-9 levels > or =200 U/ml.
CONCLUSION:
CCRT with gemcitabine-based regimens was effective in improving OS in patients with locally advanced, unresectable pancreatic cancer. We suggest that the baseline CA19-9 level is valuable in determining the treatment strategy for patients with locally advanced, unresectable pancreatic cancer.
Key Words: Pancreatic cancer, Concurrent chemoradiotherapy, Radiotherapy, CA19-9
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