Increased resectability of locally advanced pancreatic and periampullary carcinoma with neoadjuvant chemoradiotherapy

Weese, James L.; Nussbaum, Michael L.; Paul, Angela; Engstrom, Paul F.; Solin, Lawrence J.; Kowalyshyn, Michael J.; Hoffman, John P.

doi:10.1007/bf02924235

Cited by 60 publications

(3 citation statements)

References 16 publications

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“…The median survival for the former group was significantly greater than that for the latter (23 vs. 11 months); however, 5-year survival rates were not significantly different. Another study also used the FAM regimen to compare treated and nontreated groups; the 3-year survival rates were statistically similar in these patients [59]. The locoregional recurrence rates were been shown to be no higher than those observed in patients receiving EBRT in the same study.…”

Section: Adjuvant Chemotherapymentioning

confidence: 93%

Adjuvant Therapy for Pancreatic Cancer

Ghaneh¹,

Kawesha²

1999

World j. surg.

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Pancreatic cancer remains one of the leading causes of cancer related death worldwide with an overall fiveyear survival of less than 5%. Potentially curative surgery, which alone can improve 5-year survival to 10%, is an option for only 10%-20% of patients at presentation owing to local invasion of the tumour or metastatic disease. Adjuvant chemotherapy has been shown to improve 5-year survival to 20%-25% but conflicting evidence remains with regards to chemoradiation. In this article we review the current evidence available from published randomised trials and discuss ongoing phase Ⅲ trials in relation to adjuvant therapy in pancreatic cancer.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Pancreatic cancer; Adjuvant; Gemcitabine; Chemotherapy; Chemoradiotherapy; Phase Ⅲ Core tip: This paper discusses every major trial undertaken in the field of adjuvant therapy in pancreatic cancer. The evolution of chemotherapeutic regimes over the past 25 years and the controversy surrounding chemoradiation are analysed, in addition to looking at the phase Ⅲ trials currently in progress.

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Section: Adjuvant Chemotherapymentioning

confidence: 93%

Adjuvant Therapy for Pancreatic Cancer

Ghaneh¹,

Kawesha²

1999

World j. surg.

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“…Increased resectability was also noted in a series of 15 patients treated at Fox Chase Cancer Institute in Philadelphia [22]. Of the 15 patients with pancreatic cancer treated with infusion 5-FU, a bolus injection of mitomycin C, and radiation therapy, 14 patients were thought to have resectable tumors at reevaluation 3 weeks after completion of the neoadjuvant therapy.…”

Section: Attempts To Increase the Number Of Patients In Whom Resectio...mentioning

confidence: 83%

Adjuvant therapy for pancreatic cancer

Douglass

1995

World j. surg.

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Although the morbidity and mortality of pancreatic resection for cancer has been remarkably reduced during the last 20 years, there has been little change in long-term survival. Based on experience in the treatment of locally unresectable but nonmetastatic pancreatic cancer, adjuvant therapies have been devised that do have an impact on survival. The number of pancreatic resections remains low, however. To increase the number of pancreatic resections that might be performed, phase II neoadjuvant trials are under way in several centers. Even if successful, they will have little effect on the proportion of patients with pancreatic cancer who are cured. New, innovative treatments must be explored.

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“…Preoperative EBRT has been assessed in only a small number of patients with a view to improving the chance of successful resection. In several series involving neoadjuvant therapy with a total population of 83 patients, 53 cases underwent resection, with only 3 (5.7%) operative deaths 67‐71 . Positive resection margins were reported in only 8 (15%) cases, which is low compared with surgical series without preoperative radiotherapy, in which positive resection margins have been reported in as many as 51% of pancreatectomy specimens 37 …”

Section: Neoadjuvant Therapymentioning

confidence: 99%

Advances in Non‐operative Therapy in Pancreatic Cancer

Brammer

Buckels

Bramhall

2000

Int J Clinical Practice

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SUMMARYPancreatic cancer is the fifth leading cause of cancer death in the western world. The majority of patients present with advanced disease and only a few have resectable disease at presentation. This paper reviews current evidence supporting the use of conventional chemotherapy and radiotherapy in advanced disease; it goes on to review the rationale and how these data have influenced the use of radiochemotherapy in the adjuvant setting. Unpublished data from the largest adjuvant study of chemoradiotherapy in pancreatic cancer are also presented. The role of neoadjuvant therapy is discussed and how trials using this approach are evolving in pancreatic cancer. The paper finishes by reviewing the use of marimastat, a novel agent that has been extensively studied in patients with pancreatic cancer. Pancreatic cancer remains a challenge to clinicians, but increases in sub‐specialisation and a renewed interest in the disease has made the future for patients more encouraging than at any time in the past. (Int J Clin Pract 2000; 54(6): 373‐381)

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Increased resectability of locally advanced pancreatic and periampullary carcinoma with neoadjuvant chemoradiotherapy

Cited by 60 publications

References 16 publications

Adjuvant Therapy for Pancreatic Cancer

Adjuvant Therapy for Pancreatic Cancer

Adjuvant therapy for pancreatic cancer

Advances in Non‐operative Therapy in Pancreatic Cancer

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