Feasibility of pre-operative chemoradiotherapy with gemcitabine to treat pancreatic cancer in patients with impaired renal function.

Abstract

OBJECTIVE:

Although pre-operative chemoradiotherapy appears to be a promising treatment for patients with pancreatic ductal adenocarcinoma, there have been no reports of the feasibility of pre-operative chemoradiotherapy in pancreatic ductal adenocarcinoma patients with renal impairment. The aim of this study was to evaluate retrospectively the feasibility of pre-operative chemoradiotherapy in pancreatic ductal adenocarcinoma patients with renal impairment.

METHODS:

Twelve patients with resectable pancreatic ductal adenocarcinoma and a creatinine clearance of <60 ml/min were enrolled in this study. Gemcitabine-based pre-operative chemoradiotherapy was performed, followed by surgery. The feasibility of the treatment was evaluated in terms of clinical outcome and adverse events in the patients.

RESULTS:

All 12 patients completed gemcitabine-based pre-operative chemoradiotherapy without worsening of renal function. Restaging after the therapy revealed radiologically unresectable disease in two patients. Among the remaining 10 patients who underwent laparotomy, curative resection was performed in eight patients. After curative resection, five patients out of the eight completed post-operative adjuvant therapy. The 1- and 3-year survival rates after the start of chemoradiotherapy in the 12 patients were 80.8 and 36.9%, respectively.

CONCLUSIONS:

Our findings suggest that gemcitabine-based pre-operative chemoradiotherapy may be a safe and effective treatment for pancreatic ductal adenocarcinoma in patients with renal impairment.

• Authors: Yoshito Tomimaru, Hidetoshi Eguchi, Taroh Satoh, Akira Tomokuni, Tadafumi Asaoka, Hiroshi Wada, Shigeru Marubashi, Kazuhiko Ogawa, Tetsuo Takehara, Masaki Mori, Yuichiro Doki, Hiroaki Nagano
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 45 Issue 4 Pg. 343-8 (Apr 2015) ISSN: 1465-3621 [Electronic] England
• PMID: 25589454 (Publication Type: Journal Article)
• Copyright: © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected].

Chemical References

• Antimetabolites, Antineoplastic
• Deoxycytidine
• Gemcitabine

Topics

• Adult
• Aged
• Aged, 80 and over
• Antimetabolites, Antineoplastic (therapeutic use)
• Carcinoma, Pancreatic Ductal (mortality, pathology, therapy)
• Chemoradiotherapy (methods)
• Deoxycytidine (analogs & derivatives, therapeutic use)
• Feasibility Studies
• Female
• Humans
• Male
• Middle Aged
• Pancreatic Neoplasms (mortality, pathology, therapy)
• Preoperative Care
• Renal Insufficiency
• Retrospective Studies
• Survival Rate
• Treatment Outcome
• Gemcitabine