A systematic review of resectability and survival after concurrent chemoradiation in primarily unresectable pancreatic cancer
| Autor: | Luigi Sofo, Edy Ippolito, Giuseppe La Torre, Mariangela Massaccesi, Marcello Ingrosso, Rosa Tambaro, Gabriella Macchia, Vincenzo Picardi, Luciana Caravatta, Vincenzo Valentini, Francesco Deodato, Alessio G. Morganti, Adele Piscopo, Giuseppina Sallustio, Numa Cellini |
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| Přispěvatelé: | Morganti, Alessio G., Massaccesi, Mariangela, La Torre, Giuseppe, Caravatta, Luciana, Piscopo, Adele, Tambaro, Rosa, Sofo, Luigi, Sallustio, Giuseppina, Ingrosso, Marcello, Macchia, Gabriella, Deodato, Francesco, Picardi, Vincenzo, Ippolito, Edy, Cellini, Numa, Valentini, Vincenzo |
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Surgical oncology Pancreatic cancer medicine Combined Modality Therapy Humans Radical surgery Survival rate radiotherapy Neoadjuvant therapy combined modality therapy neoadjuvant therapy pancreatic neoplasms/mortality survival rate business.industry Pancreatic Neoplasm medicine.disease Neoadjuvant Therapy Surgery Radiation therapy Pancreatic Neoplasms Survival Rate Oncology Chemotherapy Adjuvant Radiotherapy Adjuvant business Chemoradiotherapy Human |
| Zdroj: | Annals of surgical oncology. 17(1) |
| ISSN: | 1534-4681 |
| Popis: | Purpose: The objective of this study was to determine the effect on resection rate and survival of neoadjuvant chemoradiotherapy for primarily unresectable locally advanced pancreatic carcinoma. Methods: A systematic review of recently published literature was performed. Resection rates and survival data were derived from reports published from 2000 onwards. Only recent studies, based on radiotherapy with standard dose and fractionation, have been analyzed. Results: Thirteen studies with a total of 510 patients met selection criteria. A resection rate of 8.3-64.2% was reported (median, 26.5%). Of the operated patients, 57.1-100% (median, 87.5%) had R0 tumor resection. Most papers reported occasional pathological complete responses (CR, 3.0-8.8%). When outcome in all patients was considered, median survival ranged from 9 to 23 (median, 13.3) months, comparing favorably with literature data based on concurrent chemoradiation alone (range, 8.6-13 months). Surprisingly, in patients with unresectable tumor at presentation, median survival after surgery ranged from 16.4 to 32.3 (median, 23.6) months. Conclusions: The finding of a high proportion of R0 resection among all resections performed confirms the activity of neoadjuvant radiochemotherapy and should not be neglected. Based on these data, patients with unresectable pancreatic cancer without disease progression after chemoradiotherapy should be considered for radical surgery. © 2009 Society of Surgical Oncology. |
| Databáze: | OpenAIRE |
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