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Small-field radiotherapy in combination with concomitant chemotherapy for locally advanced pancreatic carcinoma
Koichi Tokuuye1, Minako Sumi, Yoshikazu Kagami
1Radiation Oncology Division, The National Cancer Center Hospital, Tokyo, Japan
Purpose:
To evaluate the effectiveness of small-field radiotherapy in combination with concomitant 5-fluorouracil (5FU) or cisplatin for locally advanced pancreatic carcinoma.
Materials And Methods:
From November 1993 to January 1999, 53 patients underwent continuous 5FU infusion at 200mg/m2 (27 patients) or a 30-min cisplatin infusion at 5mg/m2/day (26 patients) just prior to each irradiation. The radiation field was limited to cover the primary and the paraaortic regions at celiac and supramesenteric axis levels. A total dose of 50.4Gy in 28 sessions was given in 5.6 weeks.
Results:
Median and 1-year survival rates were 10.2 months and 35.2%, respectively. Local failure occurred in 19 patients (36%) and liver metastases in 16 patients (30%). All local recurrences occurred only within the radiation field.
Conclusions:
Median survival rates were comparable to other studies. Because local failure occurred only within the radiation field, the use of relatively small-field radiotherapy may be justified in the treatment of locally advanced pancreatic carcinoma in addition to concurrent administration of either 5FU or cisplatin.
