Decrease in CA-19-9 after neoadjuvant chemoradiation therapy to predict survival in locally advanced pancreatic cancer
| Autor: | Jaswinder Singh, Reed Cope, Syed Faisal Jafri, Michael Burt, Jennifer Feeback, Srijita Mukherjee, Michael Connor, Joe Cates, Niharika Rath, Raj Shah, David Shaeffer, Unnati Parikh, Bradley L. Freilich, John M. Sheldon, Maninder Pabla |
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| Rok vydání: | 2012 |
| Předmět: | |
| Zdroj: | Journal of Clinical Oncology. 30:12-12 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2012.30.30_suppl.12 |
| Popis: | e14632 Background: Carcinoma of the pancreas is among the most lethal of human cancers. Data on the overall survival rates of patients treated in the community hospital setting are limited; the purpose of this retrospective data collection study was to assess – Does CA-19-9 change during the neo adjuvant treatment of locally advanced pancreatic cancer patients predicts the overall survival (OS) at high volume community hospital setting. Methods: Eligibility included cytological or histological evidence of locally advanced unresectable and borderline resectable adenocarcinoma of the pancreas, not amenable for complete surgical resection. Their respectability was determined with EUS and CT scan / MRI and was discussed in the multi disciplinary conference. Patients diagnosed before July 2009 were essentially treated with continuous 5-FU 200 mg/m2 for 5 weeks with radiation of 1.8 Gy per daily fraction, for a total dose of 50.4 Gy over 5.5 weeks. Patients diagnosed after July 2009 received gemcitabine 400 mg/m2 intravenously (over 60 minutes) beginning on the first day of radiation therapy (before radiation), then weekly thereafter during radiation. Results: Data were abstracted on 64 patients (40 deceased; 24 alive) diagnosed between 6/2005 and 4/2011. The median age was 68 years (range: 41-87), and 52% were male. The majority of patients (97%) were diagnosed by endoscopic ultrasound (EUS) with biopsy. At diagnosis, 56 (88%) patients were locally advanced unresectable(without metastasis) or borderline unresectable; 49 of these had neoadjuvant treatment, and 13 were later resected. Median OS for all 64 patients was 45.4 weeks (95% CI: 29.6-61.3), with no significant differences in OS by sex of patient (p = 0.210) or smoking history (p = 0.625). Twenty-two patients (34%) had >75% decreases in CA19-9 from baseline; median OS was 89.4 weeks in this group compared to 41.3 weeks in patients with changes in CA19-9 75% decreases in CA19-9 from baseline) in response to neo adjuvant chemotherapy and radiation. |
| Databáze: | OpenAIRE |
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