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Poster display session

3098 - Sequential Chemo-chemoradiation (CCRT) in Locally Advanced Pancreas Cancer in an Irish High Volume Centre

Date

09 Sep 2017

Session

Poster display session

Presenters

Rozana Abdul Rahman

Citation

Annals of Oncology (2017) 28 (suppl_5): v209-v268. 10.1093/annonc/mdx369

Authors

R. Abdul Rahman1, M.Y. Teo2, M. Moriarty3, R. McDermott1, G. McVey3

Author affiliations

  • 1 Medical Oncology, St Vincents University Hospital, 4 - Dublin/IE
  • 2 Oncology, Memorial Sloan-Kettering Cancer Center, 10065 - New York/US
  • 3 Radiaiton Oncology, St. Lukes Hospital, Rathgar/IE
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Resources

Abstract 3098

Background

We adopted the sequential CCRT approach for management of patients (pts) with LAPC in July 2008. Pancreas cancer care was centralised to 2 high volume cancer centres in Ireland since 2011. The objective of this study is to examine the efficacy of CCRT and its differences pre- and post-July 2008, and to compare the efficacy of newer chemo-regimens FOLFIRINOX (FFX) and Gemcitabine/nab-Paclitaxel (GA) with other regimens.

Methods

Pts were identified from the medical oncology and pancreatobiliary surgery databases. Eligible pts had pathological diagnosis of pancreatic adenocarcinoma, and radiologically and/or laparoscopically-confirmed LAPC disease with no distant metastases. Only those who commenced induction chemo were included in the final analysis. OS was calculated from date of pathological diagnosis to death.

Results

Between Mar 05 - Apr 17, 102 pts were identified. 56, 55% were male with a median age of 67 yrs (range: 42 – 87). 86 pts commenced induction chemo, with FFX+GA (15 + 5), gemcitabine (30), gemcitabine-based (24) and fluorouracil-based regimen (12). All pre-July 08 pts were treated with chemo only. Post-July 08, 70 pts commenced induction chemo, and 38, 54% went on to have sequential CRT (s-CRT). Those who received combination chemo were more likely to proceed with s-CRT, 84% vs 59% respectively, p = 0.023. 5FU was the most common radiosensitiser used (20), followed by gemcitabine (5). Median follow-up was 12.5 mos (95% CI: 11.60 -15.34). OS for all 86 pts were 13.4 mos (95% CI: 11.8- 15.0) and for post-July 08 cohort was significantly longer (14.1 mos vs 8.9 mos, HR: 0.47, 95% CI 0.26 – 0.83, p = 0.01). Amongst the post-July 08 pts, OS for patients who received s-CRT was significantly superior when compared to patients who did not (18.1 vs 10.0 mos, HR 0.35, 95% CI 0.21 – 0.58, p 

Conclusions

Our results showed superior OS for pts who received CCRT since the implementation of CCRT and centralisation of pancreas cancer care. Treatment with newer regimen appear to improve OS.

Clinical trial identification

not applicable

Legal entity responsible for the study

St. Vincent's University Hospital, Dublin, Ireland.

Funding

None

Disclosure

All authors have declared no conflicts of interest.

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