Radiotherapy for patients with isolated local recurrence of primary resected pancreatic cancer. Prolonged disease-free interval associated with favorable prognosis.

Abstract

BACKGROUND AND PURPOSE:

To evaluate the treatment outcomes of radiotherapy and prognostic factors for recurrent pancreatic cancer.

PATIENTS AND METHODS:

The study comprised 30 patients who developed a locoregional recurrence of primarily resected pancreatic cancer and received radiotherapy between 2000 and 2013 with a median dose of 54 Gy (range, 39-60 Gy). Concurrent chemotherapy included gemcitabine for 18 patients and S-1 for seven patients. The treatment outcomes and prognostic factors were retrospectively analyzed.

RESULTS:

The median follow-up after radiotherapy was 14.6 months. The 1-year overall survival, local control, and progression-free survival rates were 69%, 67%, and 32%, respectively. The median overall survival and progression-free survival rates were 15.9 and 6.9 months, respectively. Tumor marker reduction and ≥ 50% reduction were observed in 18 and two patients, respectively. Of the seven patients who exhibited pain symptoms, four and two patients were partly and completely relieved, respectively. Late grade 3 ileus and gastroduodenal bleeding were observed in one patient each. Among the clinicopathological factors evaluated, only a disease-free interval of greater than 18.9 months exhibited a significant association with improved overall survival (p = 0.017).

CONCLUSIONS:

Radiotherapy for isolated locally recurrent pancreatic cancer resulted in encouraging local control, overall survival, and palliative effects with mild toxicity, particularly in patients with a prolonged disease-free interval. This treatment strategy should be prospectively evaluated.

• Authors: Akira Nakamura, Satoshi Itasaka, Kyoichi Takaori, Yoshiya Kawaguchi, Keiko Shibuya, Michio Yoshimura, Yukinori Matsuo, Takashi Mizowaki, Shinji Uemoto, Masahiro Hiraoka
• Journal: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] (Strahlenther Onkol) Vol. 190 Issue 5 Pg. 485-90 (May 2014) ISSN: 1439-099X [Electronic] Germany
• PMID: 24599344 (Publication Type: Journal Article)

Chemical References

• Drug Combinations
• Deoxycytidine
• S 1 (combination)
• Tegafur
• Oxonic Acid
• Gemcitabine

Topics

• Adult
• Aged
• Aged, 80 and over
• Chemoradiotherapy, Adjuvant
• Combined Modality Therapy
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Disease-Free Survival
• Drug Combinations
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local (radiotherapy)
• Oxonic Acid (administration & dosage)
• Pain Measurement
• Palliative Care (methods)
• Pancreatectomy
• Pancreatic Neoplasms (mortality, pathology, therapy)
• Prognosis
• Radiotherapy Dosage
• Tegafur (administration & dosage)
• Gemcitabine