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Full-dose gemcitabine is a more effective chemotherapeutic agent than 5-fluorouracil for concurrent chemoradiotherapy as first-line treatment in locally advanced pancreatic cancer

Authors
 Kang H.  ;  Chang J.S.  ;  Oh T.G.  ;  Chung M.J.  ;  Park J.Y.  ;  Park S.W.  ;  Seong J.  ;  Song S.Y.  ;  Chung J.B.  ;  Bang S 
Citation
 Chemotherapy, Vol.60(3) : 191-199, 2015 
Journal Title
 Chemotherapy 
ISSN
 0009-3157 
Issue Date
2015
MeSH
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Chemoradiotherapy/methods ; Cisplatin/administration & dosage ; Combined Modality Therapy/methods ; Deoxycytidine/administration & dosage ; Deoxycytidine/analogs & derivatives ; Female ; Fluorouracil/administration & dosage ; Humans ; Leucovorin/administration & dosage ; Male ; Middle Aged ; Pancreatic Neoplasms/therapy* ; Retrospective Studies
Keywords
Locally advanced pancreatic cancer ; Chemoradiotherapy ; Concurrent chemoradiotherapy ; Gemcitabine ; 5-fluorouracil
Abstract
OBJECTIVES: To compare the efficacy of full-dose gemcitabine-based concurrent chemoradiotherapy (FG-CCRT) and conventional 5-fluorouracil CCRT (5FU-CCRT) for locally advanced pancreatic cancer (LAPC). METHODS: 109 LAPC cases treated with FG-CCRT (n = 89) or 5FU-CCRT (n = 20) were reviewed retrospectively. The FG-CCRT group was composed of a full-dose gemcitabine monotherapy (1,000 mg/m(2)) arm and a combination therapy with cisplatin (70 mg/m(2)) arm. The 5FU-CCRT group used a radiosensitizing dose of 5-FU (500 mg/m(2)) plus leucovorin (20 mg/m(2)). Concurrent radiotherapy was targeted at the tumor with a 5-mm margin without lymph node irradiation. RESULTS: Objective response rate (ORR) and disease control rate (DCR) was significantly higher in the FG-CCRT group (ORR: 32.6 vs. 5%, p = 0.013; DCR: 79.8 vs. 50.0%, p = 0.006). FG-CCRT showed remarkable superiority to 5FU-CCRT for suppressing distant metastasis (18.0 vs. 45.0%, p = 0.017). Neutropenia (34.8 vs. 10%, p = 0.032) and thrombocytopenia (21.3 vs. 0.0%, p = 0.021) were more frequent in the FG-CCRT group as originally expected. When dividing the FG-CCRT group to gemcitabine monotherapy (GEM) and gemcitabine plus cisplatin, toxicities of the GEM subgroup were not different than those of the 5FU-CCRT group. CONCLUSION: FG-CCRT, especially full-dose gemcitabine monotherapy-based CCRT was more effective for the initial control of LAPC than 5FU-CCRT, and also relatively safe.
Full Text
http://www.karger.com/Article/FullText/375402
DOI
10.1159/000375402
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kang, Huapyong(강화평) ORCID logo https://orcid.org/0000-0003-1790-0809
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Bang, Seungmin(방승민) ORCID logo https://orcid.org/0000-0001-5209-8351
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Oh, Tak Geun(오탁근)
Chang, Jee Suk Paul(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Chung, Moon Jae(정문재) ORCID logo https://orcid.org/0000-0002-5920-8549
Chung, Jae Bock(정재복)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139881
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