Treatment of locally advanced pancreatic cancer with concurrent chemoradiotherapy with gemcitabine: Results from 24 patients treated from 2003-2009.

Abstract

e14684 Background: Local control of locally advanced pancreatic cancer with radiotherapy plus gemcitabine has demonstrated overall survival benefit without apparent long term adverse impact on QOL when compared with gemcitabine alone. We evaluated safety and efficacy of concurrent chemoradiotherapy with gemcitabine in patients with LAPC. Methods: Patients with unresectable nonmetastatic invasive ductal pancreatic cancer with ECOG performance status of 0-1 were eligible. Surgical staging was not required. Gemcitabine was administered at 250 mg/m2 twice daily every day with 5 days per week radiotherapy (1.8 Gy fractions) over the 5 weeks followed by 6 cycles and more of gemcitabine alone (1,000 mg/m2 weekly x 3 every 4 wks). Results: From April, 2003 to January 2009, 24 patients were enrolled, 24 (100%) were patients completed concurrent chemoradiotherapy. Male:Female- 14:10 with a median age of 67 (range: 48-82). Tumor response was 0%. The confirmed tumor marker response rate(less than 50% before the treatment) is 92% (22/24). Median time to progression 6.4 mos (95% CI [2.0, 16.6]), and median survival time 11.4 mos (95% CI [6.0, 23.3]) were observed. Twelve (50%) and 7 (29%) patients experienced at least one grade 3+ or grade 4+ adverse event, respectively. The most common grade 3-4 toxicities were neutropenia (33%), anemia (17%), anorexia (25%), nausea (25%), vomiting (25%). Conclusions: concurrent chemoradiotherapy combined with gemcitabine is a well tolerated and effective treatment for patients with locally advanced pancreatic cancer. No significant financial relationships to disclose.