This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Huguet, F. Articles by Louvet, C. Search for Related Content PubMed PubMed Citation Articles by Huguet, F. Articles by Louvet, C. Social Bookmarking                            What's this?

Impact of Chemoradiotherapy After Disease Control With Chemotherapy in Locally Advanced Pancreatic Adenocarcinoma in GERCOR Phase II and III Studies

Florence Huguet, Thierry André, Pascal Hammel, Pascal Artru, Jacques Balosso, Frédéric Selle, Elisabeth Deniaud-Alexandre, Philippe Ruszniewski, Emmanuel Touboul, Roberto Labianca, Aimery de Gramont, Christophe Louvet

From the Departments of Radiation Oncology and Medical Oncology, Tenon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Department of Medical Oncology, Saint-Antoine Hospital, AP-HP, Paris; Department of Gastroenterology, Beaujon Hospital, AP-HP, Clichy; Clinique Saint Jean, Lyon; Department of Radiation Oncology, Grenoble University Hospital, Grenoble, France; and the Department of Medical Oncology, Ospedali Riuniti, Bergamo, Italy

Address reprint requests to Florence Huguet, MD, Service d'Oncologie Radiothérapie, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France; e-mail: florence.huguet{at}tnn.aphp.fr

PURPOSE: The management of locally advanced (LA) pancreatic cancer patients remains controversial. To select patients who could benefit from chemoradiotherapy (CRT), the therapeutic strategy used by the Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR) consisted of initial chemotherapy (CT) for at least 3 months. The decision to administer CRT or continue CT in nonprogressive patients was the investigator's choice.

PATIENTS AND METHODS: Retrospective analysis of outcome in 181 patients with LA pancreatic cancer (76 women and 105 men; mean age, 61 years; range, 37 to 85 years) enrolled onto prospective phase II and III GERCOR studies was performed to compare the survival of patients who received CRT with that of patients who continued CT alone.

RESULTS: Median progression-free survival (PFS) and overall survival (OS) times for the 181 patients were 6.3 and 11.4 months, respectively. Fifty-three patients (29.3%) had metastatic disease after 3 months of CT and were not eligible for CRT. Among the 128 remaining patients (70.3%) who had no disease progression and who were, therefore, eligible for CRT, 72 (56%) received CRT (group A), whereas 56 (44%) continued with CT (group B). The two groups were balanced for initial characteristics (performance status, sex, age, and type of CT), as well as for induction CT results. In groups A and B, the median PFS times were 10.8 and 7.4 months, respectively (P = .005), and the median OS times were 15.0 and 11.7 months, respectively (P = .0009).

CONCLUSION: These results suggest that, after control of disease by initial CT, CRT could significantly improve survival in patients with LA pancreatic cancer compared with CT alone. A prospective phase III study is ongoing to evaluate this strategy.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				S. Laurent, E. Monsaert, T. Boterberg, A. Demols, I. Borbath, M. Polus, A. Hendlisz, B. de Hemptinne, C. Mahin, P. Scalliet, et al. Feasibility of radiotherapy with concomitant gemcitabine and oxaliplatin in locally advanced pancreatic cancer and distal cholangiocarcinoma: a prospective dose finding phase I-II study Ann. Onc., May 20, 2009; (2009) mdp005v1. [Abstract] [Full Text] [PDF]

				F. Huguet, N. Girard, C. S.-E. Guerche, C. Hennequin, F. Mornex, and D. Azria Chemoradiotherapy in the Management of Locally Advanced Pancreatic Carcinoma: A Qualitative Systematic Review J. Clin. Oncol., May 1, 2009; 27(13): 2269 - 2277. [Abstract] [Full Text] [PDF]

				S. Cascinu, S. Jelic, and On behalf of the ESMO Guidelines Working Group Pancreatic cancer: ESMO Clinical Recommendations for diagnosis, treatment and follow-up Ann. Onc., May 1, 2009; 20(suppl_4): iv37 - iv40. [Full Text] [PDF]

				B. Chauffert, F. Mornex, F. Bonnetain, P. Rougier, C. Mariette, O. Bouche, J. F. Bosset, T. Aparicio, L. Mineur, A. Azzedine, et al. 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 the 2000-01 FFCD/SFRO study Ann. Onc., September 1, 2008; 19(9): 1592 - 1599. [Abstract] [Full Text] [PDF]

				T. B. Brunner, M. Geiger, G. G. Grabenbauer, M. Lang-Welzenbach, T. S. Mantoni, A. Cavallaro, R. Sauer, W. Hohenberger, and W. G. McKenna Phase I Trial of the Human Immunodeficiency Virus Protease Inhibitor Nelfinavir and Chemoradiation for Locally Advanced Pancreatic Cancer J. Clin. Oncol., June 1, 2008; 26(16): 2699 - 2706. [Abstract] [Full Text] [PDF]

				L. Moureau-Zabotto, J.-M. Phelip, P. Afchain, L. Mineur, T. Andre, V. Vendrely, G. Lledo, O. Dupuis, F. Huguet, E. Touboul, et al. Concomitant Administration of Weekly Oxaliplatin, Fluorouracil Continuous Infusion, and Radiotherapy After 2 Months of Gemcitabine and Oxaliplatin Induction in Patients With Locally Advanced Pancreatic Cancer: A Groupe Coordinateur Multidisciplinaire en Oncologie Phase II Study J. Clin. Oncol., March 1, 2008; 26(7): 1080 - 1085. [Abstract] [Full Text] [PDF]

				M. A. Tempero How I Treat Pancreatic Ductal Adenocarcinoma J. Oncol. Pract, January 1, 2008; 4(1): 46 - 47. [Full Text] [PDF]

				W. H. Isacoff and P. A. Philip In Reply: J. Clin. Oncol., January 1, 2008; 26(1): 162 - 164. [Full Text] [PDF]