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Preoperative chemoradiation in potentially resectable pancreatic adenocarcinoma: feasibility, treatment effect evaluation and prognostic factors, analysis of the SFRO-FFCD 9704 trial and literature review
Annals of Oncology, 06/09/09

Le Scodan R et al. - In a study to explore the feasibility and the histologic assessment of treatment effect of preoperative chemoradiation in pts presenting with resectable pancreatic adenocarcinoma, it was found that this proposed preoperative scheme is feasible, does not prevent successful surgery, and provides antitumoral effect associated with major histopathological response in 50% of pts and a high R0 resection rate.

Methods

Treatment consisted of concurrent radiotherapy (50 Gy within 5 wks) and chemotherapy with 5-fluorouracil (300 mg/m2/day, 5 days/wk, wks 1–5) and cisplatin (20 mg/m2/day, days 1–5 and 29–33), followed by surgical resection of pancreatic tumor in pts without progression.

Results

41 pts were enrolled; 38 (93%) received 47 Gy; 30 pts (73%) received 75% of the prescribed doses of chemotherapy.
Among 40 assessable pts, 27 (67.5%) were successfully treated (entire dose of radiation, 75% of the chemotherapy dose, no grade 4 non-hematologic toxicity).
26 pts (63%) underwent surgical resection with curative intent and 21 (80.7%) had R0 resection.
13 of 26 specimens (50%) presented a major pathologic response (80% of severely degenerative cancer cells), with 1 complete pathologic response.
Operative mortality was 2.8%.
Local recurrence and 2-yr survival rates were 4% and 32%, respectively, for the 26 operated pts.

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