Regional Hyperthermia Combined with Chemoradiotherapy in Primary or Recurrent Locally Advanced Pancreatic Cancer : an Open-label Comparative Cohort Trial

Overview

Journal Strahlenther Onkol

Specialties Oncology
Radiology

Date 2011 Sep 21

PMID 21932025

Citations 24

Authors

Sergio Maluta

Moshe Schaffer

Fabio Pioli

Stefano DallOglio

Stefano Pasetto

Pamela M Schaffer

Bernard Weber

Maria Grazia Giri

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the therapeutic effect of delivering regional hyperthermia (HT) plus chemoradiotherapy (CRT) in patients suffering from locally advanced unresectable pancreatic cancer (LAPC).

Methods: Between January 2000 and December 2008, 68 patients affected by primary (56/68) or recurrent (12/68) LAPC were treated either with CRT alone or CRT plus HT. Radiotherapy (RT) consisted of 3D conformal irradiation of tumor and regional lymph nodes (dose ranged from 30 Gy/10 fractions to 66 Gy/33 fractions). Chemotherapy (CT) consisted of gemcitabine (GEM) alone or in association with either oxaliplatin, cisplatin, or 5-FU. HT was delivered twice a week, concomitant with RT.

Results: In the current study, 60 of the original 68 patients were included. Median overall survival (OS) was 15 months in the HT group versus 11 months in the control group (log-rank test: p = 0.025). HT did not increase CRT toxicity.

Conclusion: HT can be added safely to CRT in LAPC, thus, resulting in slightly prolonged survival in certain cases.

Citing Articles

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References

Kido Y, Kuwano H, Maehara Y, Mori M, Matsuoka H, Sugimachi K . Increased cytotoxicity of low-dose, long-duration exposure to 5-fluorouracil of V-79 cells with hyperthermia. Cancer Chemother Pharmacol. 1991; 28(4):251-4. DOI: 10.1007/BF00685530. View

MOERTEL C, Frytak S, Hahn R, Oconnell M, Reitemeier R, Rubin J . Therapy of locally unresectable pancreatic carcinoma: a randomized comparison of high dose (6000 rads) radiation alone, moderate dose radiation (4000 rads + 5-fluorouracil), and high dose radiation + 5-fluorouracil: The Gastrointestinal Tumor Study.... Cancer. 1981; 48(8):1705-10. DOI: 10.1002/1097-0142(19811015)48:8<1705::aid-cncr2820480803>3.0.co;2-4. View

Eppinga W, Lagerwaard F, Verbakel W, Slotman B, Senan S . Volumetric modulated arc therapy for advanced pancreatic cancer. Strahlenther Onkol. 2010; 186(7):382-7. DOI: 10.1007/s00066-010-2094-5. View

Istomin Y, Zhavrid E, Sachivko N, Alexandrova E, Pocheshinsky P . The effect of cytostatics and hyperthermia on RAJI human lymphoma cells. Exp Oncol. 2011; 33(1):19-23. View

Yip D, Karapetis C, Strickland A, Steer C, Goldstein D . Chemotherapy and radiotherapy for inoperable advanced pancreatic cancer. Cochrane Database Syst Rev. 2006; (3):CD002093. DOI: 10.1002/14651858.CD002093.pub2. View

Crane C, Janjan N, Evans D, Wolff R, Ballo M, Milas L . Toxicity and Efficacy of Concurrent Gemcitabine and Radiotherapy for Locally Advanced Pancreatic Cancer. Int J Gastrointest Cancer. 2003; 29(1):9-18. View

Haveman J, Rietbroek R, Geerdink A, van Rijn J, Bakker P . Effect of hyperthermia on the cytotoxicity of 2',2'-difluorodeoxycytidine (gemcitabine) in cultured SW1573 cells. Int J Cancer. 1995; 62(5):627-30. DOI: 10.1002/ijc.2910620522. View

Eckert F, Fehm T, Bamberg M, Muller A . Small cell carcinoma of vulva: curative multimodal treatment in face of resistance to initial standard chemotherapy. Strahlenther Onkol. 2010; 186(9):521-4. DOI: 10.1007/s00066-010-2160-z. View

Huguet F, Andre T, Hammel P, Artru P, Balosso J, Selle F . Impact of chemoradiotherapy after disease control with chemotherapy in locally advanced pancreatic adenocarcinoma in GERCOR phase II and III studies. J Clin Oncol. 2007; 25(3):326-31. DOI: 10.1200/JCO.2006.07.5663. View

10.

Chauffert B, Mornex F, Bonnetain F, Rougier P, Mariette C, Bouche O . Phase III trial comparing intensive induction chemoradiotherapy (60 Gy, infusional 5-FU and intermittent cisplatin) followed by maintenance gemcitabine with gemcitabine alone for locally advanced unresectable pancreatic cancer. Definitive results of.... Ann Oncol. 2008; 19(9):1592-9. DOI: 10.1093/annonc/mdn281. View

11.

Wilkowski R, Boeck S, Ostermaier S, Sauer R, Herbst M, Fietkau R . Chemoradiotherapy with concurrent gemcitabine and cisplatin with or without sequential chemotherapy with gemcitabine/cisplatin vs chemoradiotherapy with concurrent 5-fluorouracil in patients with locally advanced pancreatic cancer--a multi-centre.... Br J Cancer. 2009; 101(11):1853-9. PMC: 2788265. DOI: 10.1038/sj.bjc.6605420. View

12.

Maeta M, Sawata T, Kaibara N . Effects of hyperthermia on the metabolism of 5-fluorouracil in vitro. Int J Hyperthermia. 1993; 9(1):105-13. DOI: 10.3109/02656739309061483. View

13.

Cohen S, Dobelbower Jr R, Lipsitz S, Catalano P, Sischy B, Smith T . A randomized phase III study of radiotherapy alone or with 5-fluorouracil and mitomycin-C in patients with locally advanced adenocarcinoma of the pancreas: Eastern Cooperative Oncology Group study E8282. Int J Radiat Oncol Biol Phys. 2005; 62(5):1345-50. DOI: 10.1016/j.ijrobp.2004.12.074. View

14.

Sultana A, Tudur Smith C, Cunningham D, Starling N, Tait D, Neoptolemos J . Systematic review, including meta-analyses, on the management of locally advanced pancreatic cancer using radiation/combined modality therapy. Br J Cancer. 2007; 96(8):1183-90. PMC: 2360143. DOI: 10.1038/sj.bjc.6603719. View

15.

Sultana A, Tudur Smith C, Cunningham D, Starling N, Neoptolemos J, Ghaneh P . Meta-analyses of chemotherapy for locally advanced and metastatic pancreatic cancer: results of secondary end points analyses. Br J Cancer. 2008; 99(1):6-13. PMC: 2453014. DOI: 10.1038/sj.bjc.6604436. View

16.

Louvet C, Andre T, Lledo G, Hammel P, Bleiberg H, Bouleuc C . Gemcitabine combined with oxaliplatin in advanced pancreatic adenocarcinoma: final results of a GERCOR multicenter phase II study. J Clin Oncol. 2002; 20(6):1512-8. DOI: 10.1200/JCO.2002.20.6.1512. View

17.

Ishii H, Okada S, Tokuuye K, Nose H, Okusaka T, YOSHIMORI M . Protracted 5-fluorouracil infusion with concurrent radiotherapy as a treatment for locally advanced pancreatic carcinoma. Cancer. 1997; 79(8):1516-20. View

18.

Milani V, Pazos M, Issels R, Buecklein V, Rahman S, Tschoep K . Radiochemotherapy in combination with regional hyperthermia in preirradiated patients with recurrent rectal cancer. Strahlenther Onkol. 2008; 184(3):163-8. DOI: 10.1007/s00066-008-1731-8. View

19.

Tinkl D, Grabenbauer G, Golcher H, Meyer T, Papadopoulos T, Hohenberger W . Downstaging of pancreatic carcinoma after neoadjuvant chemoradiation. Strahlenther Onkol. 2009; 185(9):557-66. DOI: 10.1007/s00066-009-1977-9. View

20.

Klautke G, Brunner T . Radiotherapy in pancreatic cancer. Strahlenther Onkol. 2008; 184(11):557-64. DOI: 10.1007/s00066-008-1865-8. View