Combining gemcitabine with radiation in pancreatic cancer: understanding important variables influencing the therapeutic index.

Journal Article (Review)

We compared and evaluated available laboratory and clinical data on the use of concurrent gemcitabine (Gemzar; Eli Lilly and Company, Indianapolis, IN) and radiation in pancreatic cancer to provide guidance for subsequent prospective research initiatives. Preclinical data suggest that the timing of administration of gemcitabine with respect to radiotherapy is important, but this issue has not yet been confirmed by clinical data. Phase I clinical data indicate that the amount of acute toxicity from the combination of gemcitabine and radiotherapy is strongly related to the dose and schedule of administration of gemcitabine, as well as to the radiation field size. There also appears to be an inverse linear relationship between the maximum tolerated gemcitabine dose and radiation dose. Also important, but less clear, is the infusion rate of gemcitabine as it relates to the systemic efficacy of the drug. The combination of additional agents with gemcitabine and radiation appears to be feasible. Finally, the addition of radioprotectors may enable chemotherapy dose escalation, but safe escalation of the radiotherapy dose with newer techniques has not been established. Semin Oncol 28 (suppl 10):25-33.

Full Text

Duke Authors

Cited Authors

  • Crane, CH; Wolff, RA; Abbruzzese, JL; Evans, DB; Milas, L; Mason, K; Charnsangavej, C; Pisters, PW; Lee, JE; Lenzi, R; Lahoti, S; Vauthey, JN; Janjan, NA

Published Date

  • June 2001

Published In

Volume / Issue

  • 28 / 3 Suppl 10

Start / End Page

  • 25 - 33

PubMed ID

  • 11510031

Electronic International Standard Serial Number (EISSN)

  • 1532-8708

International Standard Serial Number (ISSN)

  • 0093-7754

Digital Object Identifier (DOI)

  • 10.1053/sonc.2001.22536

Language

  • eng