Neoadjuvant chemoradiation with IMRT in resectable and borderline resectable pancreatic cancer

作者：Kharofa Jordan; Tsai Susan; Kelly Tracy; Wood Clint; George Ben; Ritch Paul; Wiebe Lauren; Christians Kathleen; Evans Douglas B; Erickson Beth^*

来源：Radiotherapy and Oncology, 2014, 113(1): 41-46.

DOI：10.1016/j.radonc.2014.09.010

• IMRT
• Pancreatic cancer
• Borderline resectable
• Neoadjuvant chemoradiation

Purpose: Neoadjuvant chemoradiation is an alternative to the surgery-first approach for resectable pancreatic cancer (PDA) and represents the standard of care for borderline resectable (BLR). %26lt;br%26gt;Materials and methods: All patients with resectable and BLR PDA treated with neoadjuvant chemoradiation using IMRT between 1/2009 and 11/2011 were reviewed. Patients were treated to a customized CTV which included the primary mass and regional vessels. %26lt;br%26gt;Results: Neoadjuvant chemoradiation was completed in 69 patients (39 BLR and 30 resectable). Induction chemotherapy was used in 32(82%) of the 39 patients with BLR disease prior to chemoXRT. All resectable patients were treated with chemoXRT alone. Following neoadjuvant treatment, 48 (70%) of the 69 patients underwent successful pancreatic resection with 47 (98%) being margin negative (RO). In 30 of the BLR patients who had arterial abutment or SMV occlusion, 19 (63%) were surgically resected and all had RO resections. The cumulative incidence of local failure at 1 and 2 years was 2% (95% CI 0-6%) and 9% (95% CI 0.6-17%) respectively. The median overall survival for all patients, patients undergoing resection, and patients without resection were 20, 26 and 11 months respectively. Sixteen (23%) of the 69 patients are alive without disease with a median follow-up of 47 months (36-60). %26lt;br%26gt;Conclusion: Neoadjuvant chemoXRT can facilitate a margin negative resection in patients with localized PCa.

• 出版日期2014-10