A pilot study of chronomodulated infusional 5-fluorouracil chemoradiation for pancreatic cancer
| Autor: | D. R. Penberthy, J. S. Minasi, Reid B. Adams, R. S. Jones, C. H. Shelton, Tyvin A. Rich |
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| Rok vydání: | 2001 |
| Předmět: |
Male
Radiation-Sensitizing Agents medicine.medical_specialty Pancreatic disease medicine.medical_treatment Adenocarcinoma Pancreatic cancer medicine Adjuvant therapy Humans Infusions Intravenous Survival analysis Aged Chronotherapy business.industry Age Factors Hematology Middle Aged medicine.disease Combined Modality Therapy Survival Analysis Acute toxicity Surgery Pancreatic Neoplasms Radiation therapy Treatment Outcome Oncology Chemotherapy Adjuvant Fluorouracil Female Radiotherapy Adjuvant business Chemoradiotherapy medicine.drug |
| Zdroj: | Annals of Oncology. 12:681-684 |
| ISSN: | 0923-7534 |
| DOI: | 10.1023/a:1011177118982 |
| Popis: | Summary Background Dose limiting acute toxicity from chemoradiation for pancreatic cancer occurs in 15%–20% of patients treated with post-operative adjuvant therapy. Reported here is a pilot study using chronomodulated infusional 5-fluorouracil (5-FU) chemoradiation (CIC) for pancreatic cancer, a treatment designed to reduce normal tissue toxicity and maintain efficacy, with specific evaluation of acute and late morbidity, patterns of disease progression, and survival. Patients and methods Twenty-three patients with adenocarcinoma of the pancreas were treated with 5-FU CIC between January 1997 and September 1999. The median age was 64, and there were 9 males and 14 females. Six patients were considered unresectable and seventeen others were treated post-operatively. The median external beam irradiation dose was 50.4 Gy. 5-FU infusion was given five days per week (300 mg/m2/d) and the median total dose was 8.4 g/m2. The chronomodulated 5-FU infusion consists of a low basal infusion rate for 16 hours followed by an eight-hour escalating-deescalating infusion peaking at 10 p.m. All patients were followed from the time of initial diagnosis until last follow-up or death; the median follow-up was 16 months. Results No RTOG grade 3 or 4 hematologic toxicity occurred. Twelve of seventeen patients treated postoperatively have been controlled locally, and seven patients have no evidence of disease. The median survival is 28 months and one-year actuarial survival is 88% in the group of resected patients. The 6 patients treated for unresectable disease have a median survival of 13 months. Conclusions Acute toxicity of 5-FU CIC appears to be less frequent and less severe than that reported with flat infusional or bolus 5-FU based chemoradiation used for adjuvant postoperative therapy for pancreatic cancer. This method may warrant further examination, as it may be attractive for the elderly or those who cannot tolerate the toxicity associated with standard post-operative treatment protocols. |
| Databáze: | OpenAIRE |
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