OUTCOMES AND TOLERABILITY OF CHEMORADIATION THERAPY FOR PANCREATIC CANCER PATIENTS AGED 75 YEARS OR OLDER
OUTCOMES AND TOLERABILITY OF CHEMORADIATION THERAPY FOR PANCREATIC CANCER PATIENTS AGED 75 YEARS OR OLDER
复制标题
DOI：
10.1016/j.ijrobp.2009.06.020
复制
发表时间：
2010-07-15
影响因子：
7
通讯作者：
Hong, Theodore S.
中科院分区：
文献类型：
--
作者：
Miyamoto, David T.;Mamon, Harvey J.;Hong, Theodore S.
目的：回顾75岁及以上高龄局限性胰腺癌患者全剂量放化疗的疗效和耐受性。方法和材料：我们回顾性分析了2002年至2007年在两个机构接受放化疗的75岁及以上非转移性胰腺癌患者。分析患者的治疗毒性、局部复发、远处转移和生存率。结果：共确定了42例接受胰腺癌放化疗的患者，中位年龄78岁（范围75-90岁）。在这些患者中，24例局部晚期疾病接受了明确的放化疗，18例疾病接受了手术和放化疗。放化疗前，东部肿瘤合作组平均表现状态为1.0 +/- 0.8,6个月平均体重减轻5.3 +/- 3.8 kg。平均辐射剂量为48.1 +/- 9.2 Gy。所有患者均接受以氟嘧啶为基础的化疗和放疗。总共有8例患者（19%）住院，7例（17%）急诊，15例（36%）放疗中断，3例（7%）化疗中断，9例（21%）未完成治疗，22例（49%）至少有一种不良事件。最常见的毒性是恶心、疼痛和无法茁壮成长。接受明确放化疗的患者的中位总生存期为8.6个月（95%可信区间，7.2-13.1），接受切除和放化疗的患者的中位总生存期为20.6个月（95%可信区间，9.5-无穷大）。结论：在这个非常高龄的胰腺癌患者和良好的东部肿瘤合作组表现状态的数据集中，放化疗后的结果与局部晚期和切除的胰腺癌患者的历史对照相似，尽管许多患者经历了大量与治疗相关的毒性。(C) 2010爱思唯尔公司
Purpose: To review the outcomes and tolerability of full-dose chemoradiation in elderly patients aged 75 years or older with localized pancreatic cancer.Methods and Materials: We retrospectively reviewed patients aged 75 years or older with nonmetastatic pancreatic cancer treated with chemoradiation therapy at two institutions from 2002 to 2007. Patients were analyzed for treatment toxicity, local recurrences, distant metastases, and survival.Results: A total of 42 patients with a median age of 78 years (range, 75-90 years) who received chemoradiation therapy for pancreatic cancer were identified. Of the patients, 24 had locally advanced disease treated with definitive chemoradiation, and 18 had disease treated with surgery and chemoradiation. Before chemoradiotherapy, the mean Eastern Cooperative Oncology Group performance status was 1.0 +/- 0.8, and the mean 6-month weight loss was 5.3 +/- 3.8 kg. The mean radiation dose delivered was 48.1 +/- 9.2 Gy. All patients received fluoropyrimidine-based chemotherapy concurrently with radiotherapy. In all, 8 patients (19%) were hospitalized, 7 (17%) had an emergency room visit, 15(36%) required a radiation treatment break, 3(7%) required a chemotherapy break, 9(21%) did not complete therapy, and 22 (49%) had at least one of these adverse events. The most common toxicities were nausea, pain, and failure to thrive. Median overall survival was 8.6 months (95% confidence interval, 7.2-13.1) in patients who received definitive chemoradiation therapy and 20.6 months (95% confidence interval, 9.5-infinity) in patients who underwent resection and chemoradiation therapy.Conclusions: In this dataset of very elderly patients with pancreatic cancer and good Eastern Cooperative Oncology Group performance status, outcomes after chemoradiotherapy were similar to those among historic controls for patients with locally advanced and resected pancreatic cancer, although many patients experienced substantial treatment-related toxicity. (C) 2010 Elsevier Inc.