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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2011

01-04-2011 | Pancreatic Tumors

Perioperative Intra-Arterial and Systemic Chemotherapy for Pancreatic Cancer

Authors: Hiroshi Takamori, MD, Keiichiro Kanemitsu, MD, Masahiko Hirota, MD, Osamu Ikeda, MD, Hiroshi Tanaka, MD, Toru Beppu, MD, Yasuyuki Yamashita, MD, Natsuo Oya, MD, Hideo Baba, MD

Published in: Annals of Surgical Oncology | Issue 4/2011

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Abstract

Background

Even after curative resection of pancreatic cancer, there is a high probability of systemic recurrence. This indicates that subclinical metastases are already present at the time of operation. The purpose of this study was to assess the feasibility and outcomes of patients who received a novel multimodality therapy combining pancreatic resection and intraoperative radiation therapy (IORT) with pre- and postoperative chemotherapy for pancreatic cancer.

Methods

For eligible patients with pancreatic cancer, 5-FU was administered at a dose of 125 mg/m2/day on days 1–5 every week as a continuous pancreatic and hepatic arterial infusion, and gemcitabine was infused intravenously at a dose of 800 mg/m2 per day once per week for 2 weeks for preoperative chemotherapy. Pancreatic resection combined with IORT was performed 1 week after preoperative chemotherapy. Postoperative chemotherapy was performed in the same way as preoperative chemotherapy. We performed an intention-to-treat analysis for all enrolled patients.

Results

This study enrolled 44 patients. The most common toxicities were hematological and gastrointestinal events. Grade 3/4 hematological toxicities were observed during preoperative chemotherapy, although there were no grade 3/4 nonhematological events. Postoperative chemotherapy-related toxicities were more critical and frequent than preoperative ones. There were no pre- or postoperative chemotherapy-associated deaths. Median overall survival was 36.5 months with 30.5% overall 5-year survival.

Conclusions

This multimodality therapy is feasible and promises to contribute to survival. It should be evaluated in a phase III setting.
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Metadata
Title
Perioperative Intra-Arterial and Systemic Chemotherapy for Pancreatic Cancer
Authors
Hiroshi Takamori, MD
Keiichiro Kanemitsu, MD
Masahiko Hirota, MD
Osamu Ikeda, MD
Hiroshi Tanaka, MD
Toru Beppu, MD
Yasuyuki Yamashita, MD
Natsuo Oya, MD
Hideo Baba, MD
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 4/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1384-6

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