The role of induction chemotherapy + chemoradiotherapy in localised pancreatic cancer: initial experience in Scotland

Grose, D. et al. (2017) The role of induction chemotherapy + chemoradiotherapy in localised pancreatic cancer: initial experience in Scotland. Journal of Gastrointestinal Oncology, 8(4), pp. 683-695. (doi: 10.21037/jgo.2017.04.01) (PMID:28890819) (PMCID:PMC5582039)

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Abstract

Background: Despite being relatively rare pancreatic cancer is one of the highest causes of death. Even within the potentially resectable group outcomes are poor. We present our initial experiences utilising a neoadjuvant approach to localised pancreatic cancer, evaluating survival, response rates and tolerability. Methods: This was a retrospective analysis of a prospectively maintained database. Patients from 2012 to 2015 referred to a busy regional Hepato-Pancreatic Biliary (HPB) MDT were included. Patients were classified according to respectability criteria (utilising NCCN guidelines) and a treatment plan agreed. Systemic therapy with either FOLFIRINOX or Gem/Cap was delivered followed by chemoradiotherapy if disease remained localised. Toxicity, response, pathological outcomes and survival were all recorded. Results: A total of 85 patients were included in the study: 45 had initially resectable disease; 19 required a response for resection and 21 had locally advanced inoperable disease; 34 patients underwent resection. The median survival for the potentially resectable group was 22.2 months while for those undergoing resection it was 37 months. Conclusions: We have demonstrated that a neoadjuvant approach is deliverable and tolerable. In addition we have demonstrated impressive survival results in patients undergoing resection with no detriment in outcome for those not proceeding to surgery.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Jamieson, Dr Nigel and Grose, Dr Derek and Graham, Dr Janet and Duthie, Dr Fraser and McKay, Mr Colin and Chang, Professor David
Authors: Grose, D., McIntosh, D., Jamieson, N., Carter, R., Dickson, E., Chang, D., Marashi, H., Wilson, C., Alfayez, M., Kerr, A., O’Donoghue, R., Haskins, L., Duthie, F., McKay, C. J., and Graham, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
Journal Name:Journal of Gastrointestinal Oncology
Publisher:Pioneer Bioscience Publishing Company
ISSN:2078-6891
ISSN (Online):2219-679X
Copyright Holders:Copyright © 2017 Journal of Gastrointestinal Oncology
First Published:First published in Journal of Gastrointestinal Oncology 8(4):683-695
Publisher Policy:Reproduced with the permission of the publisher.

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