Chemoradiation in patients with isolated recurrent pancreatic cancer - therapeutical efficacy and probability of re-resection
Habermehl D, Brecht IC, Bergmann F, Welzel T, Rieken S, Werner J, Schirmacher P, Buechler MW, Debus J, Combs SE (2013)
Publication Type: Journal article
Publication year: 2013
Journal
Book Volume: 8
Article Number: 27
Journal Issue: 1
Abstract
Background: In the present retrospective analysis we analysed the therapeutic outcome of a set of patients, who were treated with chemoradiation (CRT) for recurrent pancreatic cancer (RPC) in a single institution.Patients and Methods: Forty-one patients had a history of primary resection for pancreatic cancer. In case of an unresectable recurrency patients were treated with CRT at our institution between 2002 and 2010 with a median dose of 48.4 Gy (range 39.6-54 Gy). Concurrent chemotherapy regimes included Gemcitabine (GEM) in 37/41 patients (90%) and Fluorouracil (FU) or Capecitabine (CAP) in 4/41 patients (10%). Patients were re-evaluated after CRT with computed tomography and/or explorative laparotomy. During re-resection or laparotomy 15 patients received an additional intraoperative radiotherapy (IORT) with a median dose of 15 Gy (range 12-15 Gy). Median age was 65 years (range 39-76 years) and there were 26 male and 15 female patients.Results: The median overall survival (mOS), local control (LC) and progression-free survival (PFS) were 16.1, 13.8 and 6.9 months respectively for all patients after the first day of CRT. Re-resection was possible in five patients (12%) and a complete remission (CR) as defined by tumor-free biopsy was seen in 6 patients (15%). When re-resection could be achieved after CRT mOS was improved to 28.3 months (n = 5 patients, 95%-CI 10.2 - 46.3 months). Patients receiving IORT had a significantly improved mOS compared to no IORT (p = 0.034). Fifteen patients (37%) experienced a local tumour progression and main site of distant metastasis was the liver (11 patients, 27%).Overall treatment-related toxicity was mild, grade III hematologic toxicity was observed in 11 patients (27%). Conclusion: In summary we observed a good therapeutic response with mild to moderate toxicity levels for CRT in RPC. Overall survival and PFS were clearly improved in case of induction of a complete remission (tumor-free biopsies) or after achieving a re-resection, thus providing a curative intended therapy even in case of disease recurrence. © 2013 Habermehl et al.; licensee BioMed Central Ltd.
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Germany (DE)How to cite
APA:
Habermehl, D., Brecht, I.C., Bergmann, F., Welzel, T., Rieken, S., Werner, J.,... Combs, S.E. (2013). Chemoradiation in patients with isolated recurrent pancreatic cancer - therapeutical efficacy and probability of re-resection. Radiation Oncology, 8(1). https://doi.org/10.1186/1748-717X-8-27
MLA:
Habermehl, Daniel, et al. "Chemoradiation in patients with isolated recurrent pancreatic cancer - therapeutical efficacy and probability of re-resection." Radiation Oncology 8.1 (2013).
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