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Fluorouracil (5-FU) - External Radiotherapy (Adjuvant chemoradiation).
Abstract: Further evidence of effective adjuvant combined radiation
and chemotherapy following curative resection of pancreatic cancer. Gastrointestinal
Tumor Study Group.
The Gastrointestinal Tumor Study Group (GITSG) previously demonstrated
a significant survival advantage for patients who receive adjuvant combined
radiation and chemotherapy following curative resection of pancreatic cancer.
Median survival in the group randomized to control was
10.9 months, compared with 21.0 months
for those randomized to treatment. GITSG registered
30 additional patients, who received the
adjuvant therapy to demonstrate that the results of the randomized trial
could be replicated. Characteristics of registered patients were similar
to those of patients in the randomized phase, with the exception of an improved
performance status. The registered patients had median survival time of
18 months. Ten patients were alive at
18.9 to 42.4 months (median, 25.0.). Two-year actuarial survival was
46%
(95% confidence interval [CI], 0.28, 0.65) compared with 43% (95% CI,
0.25, 0.63) for 21 patients randomized to treatment and
18% (95% CI, 0.08, 0.36) for 22 patients
randomized to control. Based on the original study and the confirmatory
findings, the combined use of radiation therapy and fluorouracil as adjuvant
therapy after curative resection is effective and is preferred to no adjuvant
therapy.
References
Further evidence of effective adjuvant combined radiation and chemotherapy
following curative resection of pancreatic cancer. Gastrointestinal Tumor
Study Group. Cancer; 59(12):2006-10 1987
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| Regimen |
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5 - FU....... 500 mg / M2 IV
days 1 - 3,29 - 31 then weekly starting day 71
weekly for 2 years (or until disease progression)
given concurrently with XRT, 20 Gy over 2 weeks, followed by a 2 week
break, followed by an additional 20 Gy over 2 weeks
this regimen is utilized after maximal surgical resection. |
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Summary |
Confirmatory
study for effect of adjuvant chemo-radiotherapy after resection of pancreatic
cancer |
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Median Survival |
18 months
vs. 10.9 months in control |
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Two-year
actuarial survival |
46% vs. 18% in control |
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