- 7: World J Gastroenterol. 2008 Sep 14;14(34):5311-5.
Chemoradiotherapy with twice-weekly administration of low-dose gemcitabine for locally advanced pancreatic cancer.
Igarashi H, Ito T, Kawabe K, Hisano T, Arita Y, Kaku T, Takayanagi R.
of Medicine and Bioregulatory Science, Graduate School of Medical
Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka
To evaluate the chemoradiotherapy for locally advanced pancreatic
cancer utilizing low dose gemcitabine as a radiation sensitizer
administered twice weekly.
METHODS: We performed a retrospective
analysis of chemoradiotherapy utilizing gemcitabine administered twice
weekly at a dose of 40 mg/m(2). After that, maintenance systemic
chemotherapy with gemcitabine, at a dose of 1000 mg/m(2), was
administered weekly for 3 wk with 1-wk rest until disease progression
or unacceptable toxicity developed.
RESULTS: Eighteen patients with
locally advanced unresectable pancreatic cancer were enrolled. Three of
those patients could not continue with the therapy; one patient had
interstitial pneumonia during radiation therapy and two other patients
showed liver metastasis or peritoneal metastasis during an early stage
of the therapy. The median survival was 15.0 mo and the overall 1-year
survival rate was 60%, while the median progression-free survival was
8.0 mo. The subgroup which showed the reduction of tumor development,
more than 50% showed a tendency for a better prognosis; however, other
parameters including age, gender and performance status did not
correlate with survival. The median survival of the groups that died of
liver metastasis and peritoneal metastasis were 13.0 mo and 27.7 mo,
CONCLUSION: Chemoradiotherapy with low-dose gemcitabine
administered twice weekly could be effective to patients with locally
advanced pancreatic cancer; however, patients developing liver
metastases had a worse prognosis. Another chemoradiotherapy strategy
might be needed for those patients, such as administrating one or two
cycles of chemotherapy initially, followed by chemoradiotherapy for the
cases with no distant metastases.