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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2017.1
- 수록면
- 1,022 - 1,032 (11page)
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Purpose This study assessed the feasibility and compliance of induction chemotherapy with gemcitabine and cisplatin followed by simultaneous integrated boost–intensity modulated radiotherapy (SIB-IMRT) with concurrent gemcitabine in patients with locally advanced unresectable pancreatic cancer.
Materials and Methods In this trial, patients received induction chemotherapy consisting of gemcitabine (1,000 mg/m2) and cisplatin (25 mg/m2) on days 1, 8, and 15 of each treatment cycle. Patients were subsequently treated with gemcitabine (300 mg/m2/wk) during SIB-IMRT. The patients received total doses of 55 and 44 Gy in 22 fractions to planning target volume 1 and 2, respectively. As an ancillary study, digital polymerase chain reaction was performed to screen for the seven most common mutations in codons 12 and 13 of the KRAS oncogene of circulating cell free DNA (cfDNA).
Results Forty-four patients were enrolled between 2012 and 2015. Of these, 33 (75%) completed the treatment. The most common toxicities during induction chemotherapy were grades 3 and 4 neutropenia (18.2%), grade 3 nausea (6.8%) and vomiting (6.8%). The most common toxicities during SIB-IMRT were grade 3 neutropenia (24.2%) and grade 3 anemia (12.1%).
Ten patients (23%) underwent a curative resection after therapy. Median overall survival was significantly longer in patients who underwent curative resection (16.8 months vs. 11 months, p < 0.01). The median cfDNA concentration was significantly lower after treatment (108.5 ng/mL vs. 18.4 ng/mL, p < 0.001).
Conclusion Induction chemotherapy with gemcitabine and cisplatin followed by concurrent SIB-IMRT was well tolerated and active.
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참고문헌 (19)
참고문헌 신청
Ambe C / 2015 / A Metaanalysis of randomized clinical trials of chemoradiation therapy in locally advanced pancreatic cancer / J Gastrointest Cancer 46 : 284 ~ 290
Bittner MI / 2015 / Comparison of toxicity after IMRT and 3D-conformal radiotherapy for patients with pancreatic cancer : a systematic review / Radiother Oncol 114 : 117 ~ 1
Chauffert B / 2008 / Phase III trial comparing intensive induction chemoradiotherapy (60 Gy, infusional 5-FU and intermittent cisplatin) followed by maintenance gemcitabine w
Colucci G / 2002 / Gemcitabine alone or with cisplatin for the treatment of patients with locally advanced and/or metastatic pancreatic carcinoma : a prospective, randomized
Evans DB / 2015 / Non-metastatic pancreatic cancer : resectable, borderline resectable, and locally advanced-definitions of increasing importance for the optimal delivery of
Bittner MI / 2015 / Comparison of toxicity after IMRT and 3D-conformal radiotherapy for patients with pancreatic cancer : a systematic review / Radiother Oncol 114 : 117 ~ 1
Chauffert B / 2008 / Phase III trial comparing intensive induction chemoradiotherapy (60 Gy, infusional 5-FU and intermittent cisplatin) followed by maintenance gemcitabine w
Colucci G / 2002 / Gemcitabine alone or with cisplatin for the treatment of patients with locally advanced and/or metastatic pancreatic carcinoma : a prospective, randomized
Evans DB / 2015 / Non-metastatic pancreatic cancer : resectable, borderline resectable, and locally advanced-definitions of increasing importance for the optimal delivery of
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