Adjuvant therapy of resected adenocarcinoma of the pancreas

Whittington, Richard; Bryer, Mark P.; Haller, Daniel G.; Solin, Lawrence J.; Rosato, Ernest F.

doi:10.1016/0360-3016(91)90268-9

Cited by 174 publications

(61 citation statements)

References 12 publications

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“…Although our sample size is too small to draw definitive conclusions, adjuvant gemcitabine following radiation with concurrent 5-FU for patients with resected pancreatic disease has yielded response rates similar to that reported by previously published series [9,10,[25][26][27][28][29]. More encouraging is the 11-month median survival and the 48% 1-year survival reported for the 14 patients with unresectable cancer.…”

Section: Discussionsupporting

confidence: 79%

“…Maintenance 5-FU following chemoradiation was not administered in this trial. Several large prospective singleinstitution experiences also support the benefit of adjuvant chemoradiation following resection of pancreatic cancer [26][27][28][29]. For locally advanced, unresectable pancreatic cancers, GITSG, through a randomized trial, demonstrated that radiation with concurrent 5-FU followed by additional 5-FU chemotherapy resulted in a 10-month median survival as compared to 5.5 months with radiotherapy alone [11].…”

Section: Discussionmentioning

confidence: 99%

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Gemcitabine following radiotherapy with concurrent 5‐fluorouracil for nonmetastatic adenocarcinoma of the pancreas

Kachnic

Shaw

Manning

et al. 2001

Intl Journal of Cancer

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SUMMARY Gemcitabine has been shown to be an active agent in the treatment of pancreatic cancer. This study was conducted to prospectively examine the tolerance and early efficacy of adjuvant gemcitabine following radiotherapy with concurrent 5-fluorouracil (5-FU) for nonmetastatic pancreatic adenocarcinoma. Twenty-three patients, median age 64 years, were treated with combined modality therapy. Nine patients underwent tumor resection before chemoradiation; 14 patients with locally unresectable tumors received definitive chemoradiation. Radiotherapy utilized four fields to the tumor and lymphatics to 45 Gy, plus a lateral boost to 50.4 Gy. Concurrent 5-FU 500 mg/m 2 /day was administered on days 1-3 and 29-31, followed by 4 months of gemcitabine 1,000 mg/m 2 / week for 3 weeks (fourth week break). Adjuvant gemcitabine was well tolerated. Eightythree percent of the patients completed three to four cycles. The primary dose-limiting toxicity was leukopenia, which was observed in 10 patients (43%). Nonhematologic toxicities were reported in five patients (22%). There were no cases of gemcitabine-induced radiation recall and there have been no deaths attributed to treatment toxicity. Median follow-up for the 23 patients was 12 months (range, 5-50); the actuarial median survival was 13 months. This report confirms that adjuvant gemcitabine following radiotherapy with concurrent 5-FU for nonmetastatic pancreatic adenocarcinoma can be safely administered.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Gemcitabine following radiotherapy with concurrent 5‐fluorouracil for nonmetastatic adenocarcinoma of the pancreas

Kachnic

Shaw

Manning

et al. 2001

Intl Journal of Cancer

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“…17 The additional GITSG study of 30 patients using the same treatment demonstrated an MST of 18 months and a 2-year survival rate of 46%, confirming the reproducibility of their previous findings. 12 Results from previous trials, including the GITSG study, suggest an MST of 18 -23 months after curative resection of pancreatic carcinoma followed by external radiotherapy in a dose range of 35-60 Gy combined with the systemic administration of 5-FU, 2,12,13,[17][18][19] whereas the MST after surgery alone has been reported to be between 11-12 months. 2,12 Although these findings are not directly comparable to our study because of differences with regard to patient characteristics, results from the current study with regard to MTS (13.2 months in MF group and 14.6 months in the control group; data not shown) in patients with curatively resected pancreatic carcinoma are somewhat poorer than those described earlier.…”

Section: Discussionmentioning

confidence: 99%

Is postoperative adjuvant chemotherapy useful for gallbladder carcinoma?

Takada

Amano

Yasuda

et al. 2002

Cancer

573

135

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“…Moreover, with this method, the evaluation of tumor response to loco-regional therapy experiments will be optimized. Various forms of multimodal neoadjuvant and adjuvant treatments have been used in combination with surgery to improve loco regional control of solid tumors having a high incidence of local recurrence after resection, such as rectal cancer [17][18][19][20][21], soft tissue sarcomas [22] and pancreatic cancer [23,24].…”

Section: Discussionmentioning

confidence: 99%