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)

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, Professor Nigel and Grose, Dr Derek and Duthie, Dr Fraser and McKay, Mr Colin and Chang, Professor David and Graham, Dr Janet
• 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 > School 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.