The Controversial Role of Chemoradiation for Patients With Locally Advanced Pancreatic Cancer

Faris, Jason E.; Wo, Jennifer Y.

doi:10.1634/theoncologist.2013-0270

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…Unfortunately, the randomized clinical data supporting the use of RT in pancreatic cancer have shown mixed results, [1][2][3][4] thus its role in the treatment of pancreatic cancer is controversial. 8 The more recently reported LAP07 trial evaluated patients with locally advanced disease treated with chemotherapy followed by chemoradiation or additional chemotherapy. The results demonstrated that RT conferred a slight locoregional control benefit (46% vs 32%), with no observable impact on survival.…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact of Local Progression in Pancreatic Cancer

Cardillo

Seible

Fero

et al. 2018

J Natl Compr Canc Netw

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The high prevalence of distant metastatic disease among patients with pancreatic cancer often draws attention away from the local pancreatic tumor. This study aimed to define the complications and hospitalizations from local versus distant disease progression among a retrospective cohort of patients with pancreatic cancer. Records of 298 cases of pancreatic cancer treated at a single institution from 2004 through 2015 were retrospectively reviewed, and cancer-related symptoms and complications requiring hospitalization were recorded. Hospitalizations related to pancreatic cancer were attributed to either local or distant progression. Cumulative incidence analyses were used to estimate the incidence of hospitalization, and multivariable Fine-Gray regression models were used to identify factors predictive of hospitalizations. The 1-year cumulative incidences of hospitalization due to local versus distant disease progression were 31% and 24%, respectively. Among 509 recorded hospitalizations, leading local etiologies included cholangitis (10%), biliary obstruction (7%), local procedure complication (7%), and gastrointestinal bleeding (7%). On multivariable analysis, significant predictors of hospitalization from local progression included unresectable disease (subdistribution hazard ratio [SDHR], 2.42; <.01), black race (SDHR, 3.34; <.01), younger age (SDHR, 1.02 per year; =.01), tumor in the pancreatic head (SDHR, 2.19;<.01), and larger tumor size (SDHR, 1.13 per centimeter; =.02). Most patients who died in the hospital from pancreatic cancer (56%) were admitted for complications of local disease progression. Patients with pancreatic cancer experience significant complications of local tumor progression. Although distant metastatic progression represents a hallmark of pancreatic cancer, future research should also focus on improving local therapies.

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Section: Discussionmentioning

confidence: 99%

Clinical Impact of Local Progression in Pancreatic Cancer

Cardillo

Seible

Fero

et al. 2018

J Natl Compr Canc Netw

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“…[34] Locally Advanced Unresectable Pancreatic Cancer (LAPC) About 30 % of patients with LAPC do not respond to neoadjuvant treatment and develop distant metastasis within 3 months of treatment initiation. [51] Therefore for patients with locally advanced unresectable disease, an initial period of chemotherapy rather than radiation therapy (RT) or chemoradiotherapy is a reasonable approach, especially in resource limited settings. This strategy is being studied in ongoing trials.…”

Section: Neoadjuvant Therapymentioning

confidence: 99%