Induction chemotherapy with gemcitabine followed by concurrent chemoradiotherapy with capecitabine in patients with locally advanced pancreatic cancer

Abstract

Objective To evaluate the safety and efficacy of induction chemotherapy with gemcitabine followed by concurrent chemoradiotherapywith capecitabine in patients with locally advanced pancreatic cancer (LAPC).Methods A total of 42 patients with locally advanced pancreatic cancer were enrolled.All patients received seven cycles of induction chemotherapy of gemcitabine 1 000 mg/m2,once a week.Concurrent chemoradiotherapy began 1 week after completion of induction chemotherapy.Radiotherapy was delivered with a median dose of 54 Gy (34-64 Gy) with 1.8-2.0 Gy in a fraction.The radiotherapy was combined with capecitabin at a dosage of 825 mg/m2 twice daily,5 d/week.Results Twenty patients (47.6％) were evaluated as clinical benefit response (CBR).Two cases were observed with complete remission (CR),8 with partial remission (PR),27 with stable disease (SD),and 5 with progressive disease (PD).The median overall survival was 10.1 months (range of 4-36 months).The 1-,2-year overall survival rate was 38.2％ and 18.2％,respectively.Myelosuppression was recorded in 20 patients with grades 1-2,and 5 patients with grade 3.Twenty-two patients suffered from grade 1-2 gastrointestinal toxicities,while 4 patients suffered from grade 3.Conclusions The preliminary results showed that induction chemotherapy with gemcitabine followed by concurrent chemoradiotherapy with capecitabine in patients with LAPC might achieve encouraging efficacy with better tolerance. Key words: Locally advanced pancreatic cancer; Radiotherapy; Induction chemotherapy