Neoadjuvant docetaxel-based chemoradiation for resectable adenocarcinoma of the pancreas: New neoadjuvant regimen was safe and provided an interesting pathologic response.

Abstract

PURPOSE:

To assess the safety and efficacy of a new neoadjuvant chemoradiation (CRT) docetaxel-based regimen in patients with resectable adenocarcinoma of the pancreatic head or body.

PATIENTS AND METHODS:

34 patients with histologically-confirmed resectable pancreatic adenocarcinoma were included in this prospective two-center phase II study. Radiotherapy was delivered at the dose of 45 Gy in 25 fractions of 1.8 Gy per fractions, 5 days/week, over 5 weeks. Docetaxel was administered as a 1-h intravenous (IV) infusion repeated every week during 5 weeks. The dose was 30 mg/m(2)/week. All patients were restaged after completion of CRT.

RESULTS:

Tumor progression was documented in 11 patients (32%), stable disease was documented in 20 patients (59%), and partial remission was documented in 3 patients (9%). 23 patients still with local disease at restaging underwent explorative laparotomy. Of this, 17 patients (50%) had a curative pancreaticoduodenectomy with lymphadenectomy. Morbidity and mortality rates were 29% and 0%, respectively. Three patients (17%) had complete histological responses and 5 patients had minimal residual disease. All resected patients (n = 17) underwent R0 resection. The median and five-year survival times for the resected patients were 32 months and 41%, respectively. Among the resected patients, ten (59%) died as a result of recurrent pancreatic cancer without local tumor bed recurrence.

CONCLUSIONS:

Neoadjuvant docetaxel-based chemoradiation is well-tolerated. Resected patients had a prolonged survival time. Further studies are needed to confirm our findings and determine the role of such a neoadjuvant approach.

• Authors: O Turrini, M Ychou, L Moureau-Zabotto, P Rouanet, M Giovannini, V Moutardier, D Azria, J-R Delpero, F Viret
• Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Eur J Surg Oncol) Vol. 36 Issue 10 Pg. 987-92 (Oct 2010) ISSN: 1532-2157 [Electronic] England
• PMID: 20828979 (Publication Type: Clinical Trial, Phase II, Comparative Study, Journal Article, Multicenter Study)
• Copyright: Copyright © 2010. Published by Elsevier Ltd.

Chemical References

• Taxoids
• Docetaxel

Topics

• Adenocarcinoma (mortality, pathology, therapy)
• Adult
• Aged
• Combined Modality Therapy
• Confidence Intervals
• Disease-Free Survival
• Docetaxel
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Neoadjuvant Therapy
• Neoplasm Invasiveness (pathology)
• Neoplasm Staging
• Pancreatectomy (methods)
• Pancreatic Neoplasms (mortality, pathology, therapy)
• Prospective Studies
• Radiotherapy Dosage
• Radiotherapy, Adjuvant
• Risk Assessment
• Survival Analysis
• Taxoids (administration & dosage)
• Treatment Outcome