Neoadjuvant interferon‐based chemoradiation for borderline resectable and locally advanced pancreas cancer: a Phase II pilot study
| Autor: | Todd M Tuttle, Eric H. Jensen, Edward W Greeno, Leonard Armstrong, Selwyn M. Vickers, Chung K Lee, Timothy D. Sielaff |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty genetic structures medicine.medical_treatment Alpha interferon Pilot Projects Adenocarcinoma Disease-Free Survival Pancreatectomy Pancreatic cancer Antineoplastic Combined Chemotherapy Protocols medicine Humans Neoplasm Invasiveness Neoadjuvant therapy Aged Neoplasm Staging Hepatology business.industry Gastroenterology Interferon-alpha Cancer Chemoradiotherapy Adjuvant Middle Aged medicine.disease Neoadjuvant Therapy Surgery Pancreatic Neoplasms Treatment Outcome medicine.anatomical_structure Female Original Article Neoplasm Grading business Pancreas Chemoradiotherapy |
| Zdroj: | HPB. 16(2):131-139 |
| ISSN: | 1365-182X |
| DOI: | 10.1111/hpb.12086 |
| Popis: | Objectives: Neoadjuvant chemoradiotherapy (CRT) is a viable treatment strategy for patients with pancreatic cancer. This study was conducted to evaluate the Virginia Mason Protocol (5-fluorouracil, cisplatin, interferon-α and radiation) given in the neoadjuvant setting for the treatment of locally advanced pancreatic cancer. Methods: A Phase II pilot study evaluating interferon-based neoadjuvant CRT in patients with locally advanced pancreatic cancer was performed. Results: A total of 23 patients were enrolled. The mean age of the patients was 58.6 years. Of the 23 patients, seven (30.4%) completed all treatments. In the remaining 16 (69.6%) patients, treatment was interrupted as a result of toxicity. The most commonly reported effects of toxicity were leucopoenia/cytopoenia (n = 19, 82.6%) and gastrointestinal effects (n = 19, 82.6%). Surgical resection was successful in seven (30.4%) patients. Margins were negative in six (85.7%) of these seven patients. Positive lymph nodes were identified in three (42.9%) of seven patients. Overall survival was 11.5 months. Surgery provided improved survival (22.6 months) compared with CRT alone (8.8 months). Disease-free survival in resected patients was 17.2 months. Conclusions: Interferon-based neoadjuvant CRT may allow for resection of locally advanced pancreatic cancer, but with significant toxicity. In the absence of surgical resection, survival remains dismal. |
| Databáze: | OpenAIRE |
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