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World Journal of Surgery
Published in: World Journal of Surgery 7/2011

01-07-2011

NeoGemTax: Gemcitabine and Docetaxel as Neoadjuvant Treatment for Locally Advanced Nonmetastasized Pancreatic Cancer

Authors: Klaus Sahora, Irene Kuehrer, Martin Schindl, Claus Koelblinger, Peter Goetzinger, Michael Gnant

Published in: World Journal of Surgery | Issue 7/2011

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Abstract

Background

About 30% of patients with pancreatic cancer suffer from locally advanced nonmetastatic carcinoma at the time of diagnosis. We conducted a prospective phase II clinical trial using neoadjuvant chemotherapy, consisting of gemcitabine and docetaxel, to assess the rate of complete radical resection and overall survival.

Methods

Gemcitabine (900 mg/m2) and docetaxel (35 mg/m2) were given on days 1, 8, and 15 of a 28-day cycle. Two cycles were administered for a preoperative treatment duration of 8 weeks. Patients experiencing tumor regression or stable disease and improved performance status subsequently underwent surgical exploration and pancreatic resection, if feasible. All patients were followed postoperatively to assess long-term survival.

Results

A total of 25 patients were eligible and included in the intent-to-treat and evaluable population. Thirteen patients had unresectable disease at inclusion and 12 patients had borderline resectable pancreatic cancer. Finally, 8 of 25 (32%) patients underwent resection after neoadjuvant chemotherapy; 7 (87%) of these patients had R0 resection. The median overall survival of patients who underwent resection was 16 months (95% confidence interval [CI], 8–24 months) compared to 12 months (95% CI, 8–16 months) for those without resection (p = 0.276). The median recurrence-free survival rate after resection was 12 months (95% CI, 2–21 months).

Conclusions

NeoGemTax was safe and resection was feasible in a number of patients after systemic neoadjuvant treatment. Further randomized clinical trials are needed to identify novel multimodal regimens that would be able to increase the percentage of patients undergoing curative pancreatic cancer surgery despite advanced tumor stage at the time of diagnosis.
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Metadata
Title
NeoGemTax: Gemcitabine and Docetaxel as Neoadjuvant Treatment for Locally Advanced Nonmetastasized Pancreatic Cancer
Authors
Klaus Sahora
Irene Kuehrer
Martin Schindl
Claus Koelblinger
Peter Goetzinger
Michael Gnant
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 7/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-011-1113-8

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