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J Korean Soc Ther Radiol Oncol > Volume 25(4); 2007 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2007;25(4): 213-218.
The Outcome of Postoperative Radiation Therapy for Patients with Stage II Pancreatic Cancer (T3 or N1 Disease)
Sang Won Kim, Misun Chun, Myung Wook Kim, Wook Hwan Kim, Seok Yun Kang, Seung Hee Kang, Young Taek Oh, Sunyoung Lee, Juno Yang
1Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea. chunm@ajou.ac.kr
2Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
3Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea.
To analyze retrospectively the outcome of postoperative radiation therapy with or without concurrent chemotherapy for curatively resected stage II pancreatic cancer with T3 or N1 disease.
Between January 1996 and December 2005, twenty-eight patients completed adjuvant radiation therapy at Ajou University Hospital. The patients had either pathologic T3 stage or N1 stage. The radiation target volume encompassed the initial tumor bed identified preoperatively, resection margin area and celiac nodal area. In the case of N1 patients, the radiation field extended to the lower margin of the L3 vertebra for covering both para-aortic lymph nodes bearing area. The median total radiation dose was 50 Gy. Ten patients received concurrent chemotherapy.
Thirteen patients (46%) showed loco-regional recurrences. The celiac axis nodal area was the most frequent site (4 patients). Five patients showed both loco-regional recurrence and a distant metastasis. Patients with positive lymph nodes had a relatively high probability of a distant metastasis (57.1%). Patients that had a positive resection margin showed a relatively high local failure rate (57.1%). The median disease-free survival period of all patients was 6 months and the 1- and 2-year disease free survival rates were 27.4% and 8.2%, respectively. The median overall survival period was 9 months. The 2- and 3-year overall survival rates were 31.6% and 15.8%, respectively.
The pancreatic cancer patients with stage II had a high risk of local failure and a high risk of a distant metastasis. We suggest the concurrent use of an effective radiation-sensitizing chemotherapeutic drug and adjuvant chemotherapy after postoperative radiation therapy for the treatment of patients with stage II pancreatic cancer.
Key Words: Pancreatic cancer, Radiation therapy, Chemotherapy
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