Pancreatic Cancer

Kalser, Martin H.; Ellenberg, S. S.

doi:10.1001/archsurg.1985.01390320023003

Cited by 1,270 publications

(208 citation statements)

References 6 publications

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“…4 The median survival after resection is approximately 18 mo, and the 5-y overall survival rate is just 15%. Based on prospective and randomized data from Europe 5,6 and the United States, 7,8 the standard of care for adjuvant treatment remains either gemcitabine (2′,2′-difluorodeoxycytidine) or 5-fluorouracil (5-FU) monotherapy, with or without chemoradiation. In practice, gemcitabine tends to be favored over 5-FU by many oncologists since the drug has a slightly better toxicity profile.…”

Section: Introductionmentioning

confidence: 99%

dCK expression correlates with 5-fluorouracil efficacy and HuR cytoplasmic expression in pancreatic cancer

McAllister

Pineda

Jimbo

et al. 2014

Cancer Biology & Therapy

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Section: Introductionmentioning

confidence: 99%

dCK expression correlates with 5-fluorouracil efficacy and HuR cytoplasmic expression in pancreatic cancer

McAllister

Pineda

Jimbo

et al. 2014

Cancer Biology & Therapy

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“…Results from previous phase III trials comparing curative resection alone versus adjuvant treatment in PA showed that 2-year OS ranges between 15 and 23% after surgery alone [1, 2], and between 29 and 42% after postoperative RT and concomitant bolus 5-FU, followed [1, 3]or not [2]by maintenance 5-FU (table 3). A randomized trial by the Gastrointestinal Tumor Study Group (GITSG) compared surgery alone to surgery followed by RT, consisting of 40 Gy delivered as a split course, concomitant bolus 5-FU, and subsequent bolus 5-FU for 2 years [1]. A significant improvement of 2-year OS from 15 to 42%, in favor of postoperative treatment was observed [1].…”

Section: Discussionmentioning

confidence: 99%

“…A randomized trial by the Gastrointestinal Tumor Study Group (GITSG) compared surgery alone to surgery followed by RT, consisting of 40 Gy delivered as a split course, concomitant bolus 5-FU, and subsequent bolus 5-FU for 2 years [1]. A significant improvement of 2-year OS from 15 to 42%, in favor of postoperative treatment was observed [1]. However, in this trial no prospective statistical design was planned, only 43 patients were accrued during 8 years from fourteen centers, and two unplanned interim analyses were performed, thus further limiting the statistical power.…”

Section: Discussionmentioning

confidence: 99%

“…Also with regard to this issue, our data do not allow to draw definitive conclusions. In the first group of 12 patients the feasibility of RT alone, delivered with doses of 54–60 Gy, that is higher than in previous phase III trials [1, 2, 3], was explored. Subsequently, the feasibility of different schedules of concomitant chemotherapy was evaluated with the aim to select a candidate regimen for subsequent studies.…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative management of patients with pancreatic adenocarcinoma (PA) is controversial, also due to the contradictory findings and methodological drawbacks of previously reported phase III trials [1, 2, 3]. Altogether, no clear evidence of postoperative treatment efficacy is available from these trials.…”

Section: Introductionmentioning

confidence: 99%

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Final Results of a Prospective Trial of a PEFG (Cisplatin, Epirubicin, 5-Fluorouracil, Gemcitabine) Regimen Followed by Radiotherapy after Curative Surgery for Pancreatic Adenocarcinoma

Reni¹,

Passoni²,

Bonetto³

et al. 2005

Oncology

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Background: Postoperative management of patients with pancreatic adenocarcinoma (PA) is controversial. Methods: The aim of this pilot study was to assess the feasibility of postoperative combination chemotherapy followed by radiotherapy in patients aged 18–70 years with a histological diagnosis of PA, and Karnofsky performance status (KPS) ≧70. Cisplatin and epirubicin 40 mg/m² on day 1, gemcitabine 600 mg/m² on day 1 and 8, and 5-fluorouracil 200 mg/m²/day as protracted infusion (PEFG regimen) were delivered every 28 days for 4 cycles. Assuming a minimum one-year disease-free survival (DFS) of interest of 65% and a maximum of low interest of 45% (α 0.05; β 0.10), the target enrollment was 51 patients, and the strategy would be considered to deserve further analysis if more than 29 patients were DF at one-year from surgery. Results: Fifty-one patients, KPS >80: 29, median tumor size 3.5 cm, stage II/III/IVA: 2/34/13, grade 3–4: 22, positive resection margins: 26, node positive: 46, received 179 cycles of chemotherapy. Main grade 3/4 toxicity consisted of neutropenia (51%), thrombocytopenia (18%), and anemia (4%). One-year DFS was 67 ± 7%. Two-year overall survival was 53 ± 7%. Conclusion: Postoperative management of PA with this multimodality strategy was well tolerated and yielded a promising outcome.

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Preoperative Chemotherapy, Radiotherapy, and Surgical Resection of Locally Advanced Pancreatic Cancer

Wanebo

Glicksman²,

Vezeridis³

et al. 2000

Arch Surg

131

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Hypothesis: Neoadjuvant therapy has the potential to induce regression of high-risk, locally advanced cancers and render them resectable. Preoperative chemoradiotherapy is proposed as a testable treatment concept for locally advanced pancreatic cancer. Design: Fourteen patients (8 men, 6 women) with locally advanced pancreatic cancer were surgically explored to exclude distant spread of disease, to perform bypass of biliary and/or gastric obstruction, and to provide a jejunostomy feeding tube for long-term nutritional support. A course of chemotherapy with fluorouracil and cisplatin plus radiotherapy was then initiated. Reexploration and resection were planned subsequent to neoadjuvant therapy. Main Outcome Measures: Tumor regression and survival. Interventions: Surgically staged patients with locally advanced pancreatic cancer were treated by preoperative chemotherapy with bolus fluorouracil, 400 mg/m 2 , on days 1 through 3 and 28 through 30 accompanied by a 3-day infusion of cisplatin, 25 mg m 2 , on days 1 through 3 and 28 through 30 and concurrent radiotherapy, 45 Gy. Enteral nutritional support was maintained via jejunostomy tube. Results: Of 14 patients who enrolled in the protocol and were initially surgically explored, 3 refused the second operation and 11 were reexplored; 2 showed progressive disease and were unresectable and 9 (81%) had definitive resection. Surgical pathologic stages of the resected patients were: Ib (2 patients), II (2 patients), and III (5 patients). Pancreatic resection included standard

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Pancreatic Cancer

Cited by 1,270 publications

References 6 publications

dCK expression correlates with 5-fluorouracil efficacy and HuR cytoplasmic expression in pancreatic cancer

dCK expression correlates with 5-fluorouracil efficacy and HuR cytoplasmic expression in pancreatic cancer

Final Results of a Prospective Trial of a PEFG (Cisplatin, Epirubicin, 5-Fluorouracil, Gemcitabine) Regimen Followed by Radiotherapy after Curative Surgery for Pancreatic Adenocarcinoma

Preoperative Chemotherapy, Radiotherapy, and Surgical Resection of Locally Advanced Pancreatic Cancer

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