Chemotherapy and intensity-modulated radiation therapy for locally advanced pancreatic cancer achieves a high rate of R0 resection.

Journal Article (Journal Article)

BACKGROUND: To assess local control, survival and conversion to resectability among locally advanced pancreatic cancer (LAPC) patients treated with induction chemotherapy (ICT) followed by chemoradiotherapy treatment using intensity-modulated radiation therapy (IMRT). MATERIAL AND METHODS: Between 2007 and 2012, 134 LAPC patients were treated with ICT followed by IMRT. After chemoradiotherapy, 40 patients received maintenance chemotherapy. RESULTS: With a median follow-up of 20 months, median overall survival (OS) was 23 months. One- and two-year OS was 85% and 47%, respectively. On multivariate analysis, progression of disease after IMRT was associated with worse OS. Cumulative incidence of local failure was 10% at one year and 36% at two years. Twenty-six patients (19%) underwent resection after chemoradiotherapy including 22 patients (85%) with negative margins. On multivariate analysis, response to IMRT was associated with surgery (p = .01). Acute grade 3-4 hematologic and non-hematologic toxicity rates were 26% and 4.5%, respectively. CONCLUSION: IMRT is safe in patients with LAPC. Patients with non-progressive LAPC after ICT and who received IMRT had high rates of local control and prolonged survival.

Full Text

Duke Authors

Cited Authors

  • Huguet, F; Hajj, C; Winston, CB; Shi, W; Zhang, Z; Wu, AJ; O'Reilly, EM; Reidy, DL; Allen, P; Goodman, KA

Published Date

  • March 2017

Published In

Volume / Issue

  • 56 / 3

Start / End Page

  • 384 - 390

PubMed ID

  • 27796165

Pubmed Central ID

  • PMC5644019

Electronic International Standard Serial Number (EISSN)

  • 1651-226X

Digital Object Identifier (DOI)

  • 10.1080/0284186X.2016.1245862


  • eng

Conference Location

  • England