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Preoperative chemoradiation for patients with pancreatic cancer: toxicity of endobiliary stents.

Publication ,  Journal Article
Pisters, PW; Hudec, WA; Lee, JE; Raijman, I; Lahoti, S; Janjan, NA; Rich, TA; Crane, CH; Lenzi, R; Wolff, RA; Abbruzzese, JL; Evans, DB
Published in: J Clin Oncol
February 2000

PURPOSE: A recent multicenter study of preoperative chemoradiation and pancreaticoduodenectomy for localized pancreatic adenocarcinoma suggested that biliary stent-related complications are frequent and severe and may prevent the delivery of all components of multimodality therapy in many patients. The present study was designed to evaluate the rates of hepatic toxicity and biliary stent-related complications and to evaluate the impact of this morbidity on the delivery of preoperative chemoradiation for pancreatic cancer at a tertiary care cancer center. PATIENTS AND METHODS: Preoperative chemoradiation was used in 154 patients with resectable pancreatic adenocarcinoma (142 patients, 92%) or other periampullary tumors (12 patients, 8%). Patients were treated with preoperative fluorouracil (115 patients), paclitaxel (37 patients), or gemcitabine (two patients) plus concurrent rapid-fractionation (30 Gy; 123 patients) or standard-fractionation (50.4 Gy; 31 patients) radiation therapy. The incidences of hepatic toxicity and biliary stent-related complications were evaluated during chemoradiation and the immediate 3- to 4-week postchemoradiation preoperative period. RESULTS: Nonoperative biliary decompression was performed in 101 (66%) of 154 patients (endobiliary stent placement in 77 patients and percutaneous transhepatic catheter placement in 24 patients). Stent-related complications (occlusion or migration) occurred in 15 patients. Inpatient hospitalization for antibiotics and stent exchange was necessary in seven of 15 patients (median hospital stay, 3 days). No patient experienced uncontrolled biliary sepsis, hepatic abscess, or stent-related death. CONCLUSION: Preoperative chemoradiation for pancreatic cancer is associated with low rates of hepatic toxicity and biliary stent-related complications. The need for biliary decompression is not a clinically significant concern in the delivery of preoperative therapy to patients with localized pancreatic cancer.

Duke Scholars

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

February 2000

Volume

18

Issue

4

Start / End Page

860 / 867

Location

United States

Related Subject Headings

  • Stents
  • Retrospective Studies
  • Radiotherapy Dosage
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Paclitaxel
  • Oncology & Carcinogenesis
  • Neoadjuvant Therapy
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Pisters, P. W., Hudec, W. A., Lee, J. E., Raijman, I., Lahoti, S., Janjan, N. A., … Evans, D. B. (2000). Preoperative chemoradiation for patients with pancreatic cancer: toxicity of endobiliary stents. J Clin Oncol, 18(4), 860–867. https://doi.org/10.1200/JCO.2000.18.4.860
Pisters, P. W., W. A. Hudec, J. E. Lee, I. Raijman, S. Lahoti, N. A. Janjan, T. A. Rich, et al. “Preoperative chemoradiation for patients with pancreatic cancer: toxicity of endobiliary stents.J Clin Oncol 18, no. 4 (February 2000): 860–67. https://doi.org/10.1200/JCO.2000.18.4.860.
Pisters PW, Hudec WA, Lee JE, Raijman I, Lahoti S, Janjan NA, et al. Preoperative chemoradiation for patients with pancreatic cancer: toxicity of endobiliary stents. J Clin Oncol. 2000 Feb;18(4):860–7.
Pisters, P. W., et al. “Preoperative chemoradiation for patients with pancreatic cancer: toxicity of endobiliary stents.J Clin Oncol, vol. 18, no. 4, Feb. 2000, pp. 860–67. Pubmed, doi:10.1200/JCO.2000.18.4.860.
Pisters PW, Hudec WA, Lee JE, Raijman I, Lahoti S, Janjan NA, Rich TA, Crane CH, Lenzi R, Wolff RA, Abbruzzese JL, Evans DB. Preoperative chemoradiation for patients with pancreatic cancer: toxicity of endobiliary stents. J Clin Oncol. 2000 Feb;18(4):860–867.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

February 2000

Volume

18

Issue

4

Start / End Page

860 / 867

Location

United States

Related Subject Headings

  • Stents
  • Retrospective Studies
  • Radiotherapy Dosage
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Paclitaxel
  • Oncology & Carcinogenesis
  • Neoadjuvant Therapy
  • Middle Aged
  • Male