Clinical Study

Neoadjuvant 5 Fluorouracil-Cisplatin Chemoradiation Effect on Survival in Patients with Resectable Pancreatic Head Adenocarcinoma: A Ten-Year Single Institution Experience
Olivier Turrini^a, Frédéric Viret^b, Laurence Moureau-Zabotto^c, Jérome Guiramand^a, Vincent Moutardier^a, Bernard Lelong^a, Cécile de Chaisemartin^a, Marc Giovannini^d, Jean-Robert Delpero^a

Departments of
^aSurgical Oncology,
^bMedical Oncology,
^cRadiotherapy, and
^dEndoscopy, Institut Paoli-Calmettes and Université de la Méditerranée Marseille, Marseille, France

Address of Corresponding Author

Oncology 2009;76:413-419 (DOI: 10.1159/000215928)

  Key Words

• Neoadjuvant
• Pancreatic adenocarcinoma
• Chemoradiation
• Pancreatic cancer

  Abstract

Objectives: It is the aim of this study to assess the outcome of patients who received neoadjuvant 5-fluorouracil-cisplatin chemoradiation (CRT) for stage I/III pancreatic adenocarcinoma. Methods: Eligible patients (n = 101) received radiation therapy (45 Gy) associated with continuous infusion of 5-fluorouracil accompanied by a cisplatin bolus. Results: Of the 102 patients enrolled in the study, 26 patients had progression of cancer during treatment and were deemed unresectable; 1 patient died during CRT of septic shock. Sixty-two of 75 remaining patients underwent pancreaticoduodenectomy. The overall median survival of all 102 patients in the study was 17 months, with a 5-year survival of 10%. For patients who underwent resection, the median survival was 23 months. Correspondingly, the median survival was 11 months for the 40 unresected patients (p = 0.002). The 5-year survivals for resected and unresected patients were 18 and 0% (p = 0.01), respectively. A complete pathological response to neoadjuvant CRT was noted for 8 patients (13%). Margin and lymph node positivity was present in 5 (8%) and 15 (24%) patients, respectively. There was documented local recurrence in 8 (13%) and distant recurrence in 36 (58%) patients, with the liver being the most common site. Conclusion: Neoadjuvant 5-fluorouracil-based CRT had a limited impact on survival but appeared to be associated with improved local control.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Olivier Turrini
Institut Paoli-Calmettes
232, Bd de Sainte Marguerite
FR–13009 Marseille (France)
Tel. +33 491 22 36 60, Fax +33 491 22 35 50, E-Mail turrinio@marseille.fnclcc.fr

  Article Information

Received: October 13, 2008
Accepted after revision: December 18, 2008
Published online: May 4, 2009
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 4, Number of References : 30