P-042 - Institutional experience in induction chemotherapy and neoadjuvant IMRT for borderline resectable and locally advanced pancreatic adenocarcinoma

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
Pancreatic Cancer
Surgery and/or Radiotherapy of Cancer
Presenter M.V. de Torres Olombrada
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors M.V. de Torres Olombrada1, I. Juez Martel1, T. Garcia Canibano1, D. Gutierrez Abad1, F. Pereira Perez1, B. Ludeña Martinez2
  • 1H Universitario Fuenlabrada, Fuenlabrada/ES
  • 2H Univerditario Fuenlabrada, Fuenlabrada/ES

Abstract

Introduction

Update our institutional experience on neoadjuvant treatment of borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer

Methods

We updated our institutional outcomes with a neoadjuvant chemotherapy and IMRT. We analyzed all BRPC and LAPC patients treated with our departmental.

Medically fit patients underwent chemotherapy for 2-3 months, with regimen at the discretion of the treating medical oncologist.

Patients then received IMRT delivered in 28 consecutive daily fractions with median total radiation doses of 50.4 Gy with concomitant chemotherapy. This was followed by restaging imaging for possible resection. Overall survival (OS), event free survival (EFS), and locoregional control (LRC) rates were estimated and compared by Kaplan-Meier and log-rank methods.

Results

We identified 27 patients, 11 BRPC and 16 LAPC, with 11.0 months median overall follow-up. The resection and margin negative (R0) rate for BRPC patients who completed neoadjuvant therapy was 53.8% and 69.2% R1-R2. Estimated median OS was 18.48 months for BRPC patients and 12.2 months for LAPC patients. Median OS was 25.67 months for surgically resected patients versus 10.03 months for unresected patients (p < 0.808).

In LAPC, 5 patients were treated after local relapse median OS in this subgroup was 35.63 months. Only 2 patients interrupted IMRT due to radiation-related toxicity.

Conclusion

Chemo radiotherapy in BRPC and LAPC pancreatic cancer is safety and may improve survival in these patients of poor prognosis.