Preoperative gemcitabine-based chemoradiation for patients with resectable adenocarcinoma of the pancreatic head
Preoperative gemcitabine-based chemoradiation for patients with resectable adenocarcinoma of the pancreatic head
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DOI：
10.1200/jco.2007.15.8634
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发表时间：
2008-07-20
影响因子：
45.3
通讯作者：
Wolff, Robert A.
中科院分区：
文献类型：
--
作者：
Evans, Douglas B.;Varadhachary, Gauri R.;Wolff, Robert A.
目的：我们进行了一项II期临床试验，以评估I/II期胰腺癌术前接受吉西他滨为主的放化疗和胰腺切除术（PD）的患者的结局。患者和方法：符合条件的胰头/钩突腺癌患者和放射学定义的潜在可切除疾病接受每周7次吉西他滨静脉（IV）输注的放化疗（400 mg/m（2）静脉注射，持续30分钟）加放射治疗（30戈伊，分10次，持续2周）。患者进行再分期4至6周后完成放化疗，并在没有疾病进展，被带到surgery.ResultsThe研究招募了86例患者。在再分期时，疾病进展或体力状态下降使13例患者无法接受手术。86名患者中有73名（85%）接受了手术，9名患者发现了胰腺外疾病，86名患者中有64名（74%）接受了成功的PD。中位总生存期（86例患者）为22.7个月，5年生存率为27%。64例接受PD的患者中位生存期为34个月，22例未切除患者中位生存期为7个月（P
Purpose We conducted a phase II trial to assess the outcomes of patients who received preoperative gemcitabine-based chemoradiation and pancreaticoduodenectomy (PD) for stage I/II pancreatic adenocarcinoma.Patients and MethodsEligible patients with pancreatic head/uncinate process adenocarcinoma and radiographically defined potentially resectable disease received chemoradiation with 7 weekly intravenous (IV) infusions of gemcitabine (400 mg/m(2) IV over 30 minutes) plus radiation therapy (30 Gy in 10 fractions over 2 weeks). Patients underwent restaging 4 to 6 weeks after completion of chemoradiation and, in the absence of disease progression, were taken to surgery.ResultsThe study enrolled 86 patients. At the time of restaging, disease progression or a decline in performance status precluded 13 patients from surgery. Seventy-three (85%) of 86 patients were taken to surgery, extrapancreatic disease was found in nine, and 64 (74%) of 86 underwent a successful PD. Median overall survival (86 patients) was 22.7 months with a 27% 5-year survival. Median survival was 34 months for the 64 patients who underwent PD and 7 months for the 22 unresected patients (P