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01-05-2017 | Original Article

A phase II trial of neoadjuvant chemoradiotherapy with intensity-modulated radiotherapy combined with gemcitabine and S-1 for borderline-resectable pancreatic cancer with arterial involvement

Authors: Yuichi Nagakawa, Yuichi Hosokawa, Hidetsugu Nakayama, Yatsuka Sahara, Chie Takishita, Tetsushi Nakajima, Yousuke Hijikata, Kazuhiko Kasuya, Kenji Katsumata, Koichi Tokuuye, Akihiko Tsuchida

Published in: Cancer Chemotherapy and Pharmacology | Issue 5/2017

Abstract

Purpose

Chemoradiotherapy using intensity-modulated radiotherapy (IMRT) is expected to provide a powerful alternative to conventional chemotherapy with a low incidence of adverse events. This study evaluated the efficacy of intensity modulated radiotherapy in combination with gemcitabine and S-1 as neoadjuvant chemoradiotherapy (NACRT) for borderline-resectable pancreatic cancer with arterial involvement (BR-A).

Methods

A total of 27 patients with BR-A were enrolled in this study between February 2012 and September 2015. IMRT was administered at 50.4 Gy in 28 fractions with concurrent gemcitabine at a dose of 600 mg/m² and S-1 at a dose of 60 mg.

Results

Only one patient (3.5%) experienced gastrointestinal adverse events at grade 3 or higher. Nineteen patients (70.3%) underwent resection, and R0 resection was achieved in 18 patients (94.7%). Thirteen patients (68.4%) developed distant metastasis at the initial site of recurrence after resection. Local recurrence developed in only one of these patients (7.7%). The median overall survival and 1-year survival rates were 22.4 months and 81.3%, respectively.

Conclusions

Concurrent IMRT with gemcitabine and S-1 for patients is feasible as NACRT for BR-A with low gastrointestinal toxicity. IMRT can be employed as a standard radiotherapy to provide more effective NACRT with powerful chemotherapy drugs.

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Title: A phase II trial of neoadjuvant chemoradiotherapy with intensity-modulated radiotherapy combined with gemcitabine and S-1 for borderline-resectable pancreatic cancer with arterial involvement
Authors: Yuichi Nagakawa
Yuichi Hosokawa
Hidetsugu Nakayama
Yatsuka Sahara
Chie Takishita
Tetsushi Nakajima
Yousuke Hijikata
Kazuhiko Kasuya
Kenji Katsumata
Koichi Tokuuye
Akihiko Tsuchida
Publication date: 01-05-2017
Publisher: Springer Berlin Heidelberg
Published in: Cancer Chemotherapy and Pharmacology / Issue 5/2017
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-017-3288-7

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