| 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. |
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| 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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