Browse > Article

The Results of Palliative Radiation Therapy in Patients with Unresectable Advanced Pancreatic Cancer  

Ryu, Mi-Ryeong (Department of Radiation Oncology, Kangnam St. Mary's Hpspital, The Catholic University of Korea)
Yoon, Sei-Chul (Department of Radiation Oncology, Kangnam St. Mary's Hpspital, The Catholic University of Korea)
Kim, Yeon-Sil (Department of Radiation Oncology, Kangnam St. Mary's Hpspital, The Catholic University of Korea)
Chung, Su-Mi (Department of Radiation Oncology, Kangnam St. Mary's Hpspital, The Catholic University of Korea)
Publication Information
Radiation Oncology Journal / v.24, no.4, 2006 , pp. 243-247 More about this Journal
Abstract
$\underline{Purpose}$: To evaluate the treatment results and prognostic factors of palliative radiation therapy in the patients with unresectable advanced pancreatic cancer. $\underline{Materials\;&\;Methods$: Thirty-seven evaluable patients with unresectable advanced pancreatic cancer who were treated by palliative radiation therapy for pain relief at the Department of Radiation Oncology, Kangnam St. Mary's hospital, the Catholic University of Korea between March 1984 and February 2005 were analysed retrospectively. There were 22 men and 15 women. Age at diagnosis ranged from 30 to 80 (median 57) years. Twelve patients (32.4%) had liver metastases and 22 patients (59.5%) had lymph node metastases. Radiation therapy was delivered to primary tumor and regional lymph nodes with $1{\sim}2\;cm$ margin, and total dose was $3,240{\sim}5,580\;cGy$ (median 5,040 cGy). Chemotherapy with radiotherapy was delivered in 30 patients (81%) with 5-FU alone (21 patients) or gemcitabine (9 patients). The follow-up period ranged from 1 to 44 months. Survival and prognostic factors were analysed using Kaplan-Meier method and log-rank test respectively. $\underline{Results}$: Overall mean and median survival were 11 and 8 months and 1-year survival rate was 20%. Among 33 patients who were amenable for response evaluation, 7 patients had good response and 22 patients had fair response with overall response rate of 87.9%. Mild to moderate toxicity were observed in 14 patients with nausea, vomiting, and indigestion, but severe toxicity requiring interruption of treatment were not observed. Chemotherapy didn't influence the survival and symptomatic palliation, but the group containing gemcitabine showed a tendency of longer survival (median 12 months) than 5-FU alone group (median 5.5 months) without statistical significance (p>0.05). The significant prognostic factors were Karnofsky performance status and liver metastasis (p<0.05). Age, sex, tumor location, lymph node metastasis, and CA 19-9 level did not show any prognostic significance (p>0.05). $\underline{Conclusion}$: Radiation therapy was effective for symptomatic palliation in the patients with unresectable advanced pancreatic cancer and would play an important part in the survival benefit with gemcitabine or other targeted agents.
Keywords
Unresectable pancreatic cancer; Radiation therapy; Symptomatic palliation;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Hoyer M, Roed H, Sengelov L, et al. Phase-II study on stereotactic radiotherapy of locally advanced pancreatic carcinoma. Radiother Oncol 2005;76:48-53   DOI   ScienceOn
2 Choi CW, Kim MS, Cho CK, et al. Locally advanced, unresectable pancreatic cancer treated by stereotactic radiation therapy. J Korean Soc Ther Radiol Oncol 2006;24:11-20   과학기술학회마을
3 Palmer KR, Kerr M, Knowles G, Cull A, Carter DC, Leonard RC. Chemotherapy prolongs survival in inoperable pancreatic carcinoma. Br J Surg 1994;81:882-885   DOI   ScienceOn
4 Brasiunas V, Brasiuniene B, Juozaityte E, Barauskas G. Evaluation of clinical factors and treatment results in patients with advanced pancreatic cancer. Medicina (Kaunas) 2004;40:1074-1080
5 Jemal A, Thomas A, Murray T, Thun M. Cancer statistics 2002. CA Cancer J Clin 2002;52:23-47   DOI   ScienceOn
6 Gastrointestinal Tumor Study Group. Radiation therapy combined with adriamycin or 5-fluorouracil for the treatment of locally unresectable pancreatic carcinoma. Cancer 1985;56: 2563-2568   DOI   ScienceOn
7 Thoson BNJ, Banting SW, Gibbs P. Pancreatic cancer: current management. Austr Fam Phys 2006;35:212-216
8 Geer RJ, Brennan MF. Prognostic indicators for survival after resection of pancreatic adenocarcinoma. Am J Surg 1993;165: 68-73   DOI   ScienceOn
9 Wong AA, Delclos ME, Wolff RA, et al. Radiation dose considerations in the palliative treatment of locally advanced adenocarcinoma of the pancreas. Am J Clin Oncol 2005;28: 227-233   DOI   ScienceOn
10 Moore MJ, Hamm J, Dancey J, et al. Comparison of gemcitabine versus the matrix metalloproteinase inhibitor BAY 12-9566 in patients with advanced or metastatic adenocar-cinoma of the pancreas: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 2003;21:3296-3302   DOI   ScienceOn
11 Moore MJ. Pancreatic cancer: what the oncologist can offer for palliation. Can J Gastroenterol 2002;16:121-124
12 Evans DB, Abbruzzese JL, Willett CG. Cancer of the pancreas. In: DeVita VT, Hellman S, Rosenberg SA, eds. Cancer-principles and practice of oncology. 6th ed. Philadelphia, PA: Lippincott Williams and Wilkins, 2001:1126-1161
13 Central Cancer Registry Center Ministry of Health and Welfare, Korea. Annual report of the central cancer registry in Korea 2004
14 Glimelius B. Chemotherapy in the treatment of cancer of the pancreas. J Hepatobiliary Pancreat Surg 1998;5:235-241   DOI
15 Goldstein D, Carroll S, Apte M, Keogh G. Modern management of pancreatic carcinoma. Intern Med J 2004;34: 475-481   DOI   ScienceOn
16 Bramhall SR, Allum WH, Jones AG, Allwood A, Cummins C, Neoptolemos JP. Treatment and survival in 13,560 patients with pancreatic cancer, and incidence of the disease, in the West Midlands: an epidemiological study. Br J Surg 1995;82: 111-115   DOI   ScienceOn
17 Moertel CG, Childs DS, Reitmeier RJ, Colby MY, Holbrook MA. Combined 5-fluorouracil and supervoltage radiation therapy of locally unresectable gastrointestinal cancer. Lancet 1969;2:865-867
18 Dobelbower RR, Borgelt BB, Strubler KA, Kutcher GJ, Suntharalingam N. Precision radiotherapy for cancer of the pancreas: technique and results. Int J Radiat Oncol Biol Phys 1980;6:1127-1133   DOI   ScienceOn
19 Li C, Chao Y, Chi K, et al. Concurrent chemoradiotherapy treatment of locally advanced pancreatic cancer: gemcitabine versus 5-fluorouracil, a randomized controlled study. Int J Radiat Oncol Biol Phys 2003;57:98-104   DOI   ScienceOn
20 Willett CG, Czito BG, Bendell JC, Ryan DP. Locally advanced pancreatic cancer. J Clin Oncol 2005;23:4538-4544   DOI   ScienceOn
21 Haslam JB, Cavanaugh PJ, Stroup SL. Radiation therapy in the treatment of irresectable adenocarcinoma of the pancreas. Cancer 1973;32:1341-1345   DOI   ScienceOn