Vooraf aan bestraling chemo in de vorm van 5-FU en cisplatin geeft bij alvleesklierkanker een iets betere controle op lokale alvleesklierkanker maar geeft geen aantoonbare winst in overall overleving. Aldus de resultaten uit een 10 jarige studie in 1 bepaald ziekenhuis met 101 alvleesklierkankerpatienten stadium I tot III. Dit lijkt toch wel een dramatisch resultaat als u bedenkt dat in deze groep patienten geen patienten met stadium IV zijn meegenomen en een aantal nog maar stadium I en II hadden., dus operabel. De mediane overall overleving was slechts 17 maanden.  De mediane overal overleving voor inoperabele alvleesklierkankerpatienten was slechts 11 maanden, met chemo en bestraling.

Neoadjuvant 5 Fluorouracil-Cisplatin Chemoradiation Effect on Survival in Patients with Resectable Pancreatic Head Adenocarcinoma: A Ten-Year Single Institution Experience.

Department of Surgical Oncology, Institut Paoli-Calmettes and Université de la Méditerranée Marseille, Marseille, France.

Objectives: It is the aim of this study to assess the outcome of patients who received neoadjuvant 5-fluorouracil-cisplatin chemoradiation (CRT) for stage I/III pancreatic adenocarcinoma.

Methods: Eligible patients (n = 101) received radiation therapy (45 Gy) associated with continuous infusion of 5-fluorouracil accompanied by a cisplatin bolus.

Results: Of the 102 patients enrolled in the study, 26 patients had progression of cancer during treatment and were deemed unresectable; 1 patient died during CRT of septic shock. Sixty-two of 75 remaining patients underwent pancreaticoduodenectomy. The overall median survival of all 102 patients in the study was 17 months, with a 5-year survival of 10%. For patients who underwent resection, the median survival was 23 months. Correspondingly, the median survival was 11 months for the 40 unresected patients (p = 0.002). The 5-year survivals for resected and unresected patients were 18 and 0% (p = 0.01), respectively. A complete pathological response to neoadjuvant CRT was noted for 8 patients (13%). Margin and lymph node positivity was present in 5 (8%) and 15 (24%) patients, respectively. There was documented local recurrence in 8 (13%) and distant recurrence in 36 (58%) patients, with the liver being the most common site.

Conclusion: Neoadjuvant 5-fluorouracil-based CRT had a limited impact on survival but appeared to be associated with improved local control. Copyright © 2009 S. Karger AG, Basel.

PMID: 19407474 [PubMed - as supplied by publisher]