P-168 - Definitive 3D concurrent chemoradiotherapy in locally advanced pancreatic cancer

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. Khalaf
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors M. Khalaf1, E. Elgezawy1, M. Eldeen1, S. Eid1, I. Aboeleuon2, H. Hamza2
  • 1Assiut University Hospital, Assiut/EG
  • 2South Egypt Cancer Institute, Assiut/EG

Abstract

Introduction

According to Egyptian National Cancer Institute, pancreatic cancer accounts for 2.3% of all cancer incidences and it is the 9th most common cancer in both men and women and 5th most common cause related to cancer death. Locally advanced pancreatic cancer represents about 25% of pancreatic cancer cases at presentation, in which the tumor has not metastasized but encases the celiac axis or superior mesenteric artery, and is considered unresectable. Patients with limited vascular involvement by tumor are considered to have borderline resectability and are often treated as locally advanced pancreatic cancer. Treatments range from chemoradiation to chemotherapy alone to induction chemotherapy followed by chemoradiation for patients who do not metastasize. Overall Survival and Progression Free Survival of locally advanced pancreatic cancer has been decreasing and a few knowledge about prognostic factors of the disease. This study was to analyze overall survival and prognostic factors of patients treated with concurrent chemoradiotherapy (CCRT) by using 3 Dimensional Radiotherapy (3DRTH) in locally advanced pancreatic cancer.

Methods

Medical records of 11 patients diagnosed with unresectable pancreatic cancer and treated with neoadjuvant treatment followed by definitive CCRT then adjuvant treatment with the same regimen of the neoadjuvant, from August 2012 to January 2015, were reviewed. Prescribed radiation dose was 36 Gy (2.4 Gy per fraction), once daily. Neoadjuvant and adjuvant chemotherapy regimen will be XELOX, while the concurrent will be weekly Gemcitabine.

Results

With a mean follow-up of 29 months (range, 20 to 35 months), median overall survival was 26 months. The 1- and 2-year survival rates were and, respectively. Median and mean time to progression were 24 and 27 months, respectively. Prognostic parameters related to overall survival were post-CCRT CA19-9 (p =0.041), the Eastern Cooperative Oncology Group (ECOG) status (p < 0.05), radiation technique (p < 0.05) and radiation dose (p < 0.05) according to univariate analysis.

Conclusion

Overall treatment results in locally advanced pancreatic cancer are relatively poor but this regimen revealed to be fair. There are few improvements in management of those patients in past decades, which affect directly their outcomes, Post-treatment CA19-9 and ECOG performance status 0 and 1and Toxicities Grade 1 and 2 were significantly associated with an improved overall survival.