Table 2 Selected studies of neoadjuvant chemoradiotherapy
From: The role of radiotherapy in multimodal treatment of pancreatic carcinoma
Study Institution | Number of patients | Total dose of RT (Gy) | Chemo-therapy | Median OS (months) | 1(2,4,5)-year-OS-rate (%) | Rate of local recurrence (%) | Rate of resectability (%) | Rate of clear resections |
|---|---|---|---|---|---|---|---|---|
multi-centric* | 53 | 50.4 | 5-FU/MMC | 9.7 all pts 15.7 res | 2y: 27 res | 24/53 (26%) 3/24 (13%) res | 24/53 (45%) | n.a. |
Snady et al. 2000[39] Mount Sinai* | 159 68* (20 res*) vs 91 adj | 54 +14 Gy | 5-FU/Cis/ Streptozotocin | 23.6* (32 res) vs 14.0 | 1 y: 86*(89)vs 64 2y: 58*(60) vs 32 3y: 27*(40)vs 17 | n.a. | 20/68 (29%) - | 95% neo 84% adj |
Breslin et al. 2001[75] MDACC# | 132 | 45 or 50.4 Gy or 10 × 3 Gy ± IORT | 5-FU, or Tax or Gem | 21 | 1y: 75 2y: 40 5y: 23 | 8/132 (6%) | - | 88% |
Sasson AR et al.2003[76] FCCC* | 116 61 neo 55 adj | 50.4 | 5-FU/MMC or Gem | All 18 neo 23 adj 16 | n.a. | n.a. | - | 39% n.a. n.a. |
White et al. 2005[68] Duke# | 193 i.p.r.:102 i.l.a.: 91 | 45 +5.4 Gy | 5-FU or Gem | 23 39 i.p.r. 20 i.l.f. | 3y: 37 res 5y: 27 res | n.a. | 70/193 (36%) 54/102 (53%) 16/91 (18%) | 73% n.a. n.a. |
Evans et al. pII 2008[11] * MDACC | i.p.r.: 86 (64 res) | 30 Gy (in 10 fractions) | Gem (7 × 400 mg) | 23 34 | 1y: 92 res 2y: 62 res 5y: 36 res | 7/64 (11%) | 64/86 (74%) | 11% |
Golcher et al. 2008[43]# Erlangen | 79 21 neo* 58 res^ | 50.4 Gy +5.4 Gy | 5-FU or Gem | 54 neo-res 21 no CRT res | 2y: 56 neo-res 43 no CRT res | n.a. | 21/103(20%) | 90% neo 78% res |
Gillen et al. meta-analysis 2010[44] | All: 4,394 i.p.r.: 32% i.l.a.: 51% both: 17% | >60%: 40-60 Gy | 50% 5-FU(+) 40% Gem(+) | i.p.r.: 23 i.l.a.: 21 | i.p.r/i.l.a. 1y 78/78 2y 47/50 | n.a. | i.p.r.: 74% I.l.a.: 33% | i.p.r.: 82% I.l.a.: 79% |
Stessin et al. SEER 2008[35] | i.p.r.: 3,885 70 neo 1,478 adj RT 2,337 obs | n.a. | n.a. | 23 neo 17 adj 12 obs | Neo/adj/obs 1y 79/68/50 2y 49/34/28 | n.a. | n.a. | n.a. |