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Multimodal Treatment with GEMOX Plus Helical Tomotherapy in Unresectable Locally Advanced Pancreatic Cancer: A Pooled Analysis of Two Phase 2 Studies
| Content Provider | MDPI |
|---|---|
| Author | Passardi, Alessandro Rapposelli, Ilario Giovanni Scarpi, Emanuela Sullo, Francesco Giulio Bartolini, Giulia Neri, Elisa Ghigi, Giulia Tontini, Luca Ercolani, Giorgio Monti, Manlio Ruscelli, Silvia Matteucci, Laura Valgiusti, Martina Frassineti, Giovanni Luca Romeo, Antonino |
| Copyright Year | 2021 |
| Description | In locally advanced pancreatic cancer (LAPC), the combination of chemotherapy and radiotherapy is a widely used treatment option. We performed a pooled analysis, including an exploratory analysis for prognostic and predictive factors, of two phase 2 trials including 73 patients with LAPC, treated with gemcitabine and oxaliplatin (GEMOX) and hypofractionated tomotherapy. With a median follow-up of 36 months (range 1–65), median progression-free (PFS) and overall survival (OS) were 10.2 (95% confidence interval [CI] 7.8–13.2) and 14.3 (95% CI 12.0–18.1) months, respectively. The overall resectability rate was 23.3% (95% CI 13.6–33.0), and the R0 resection rate was 13.7% (95% CI 5.8–21.6). In the multivariate analysis, ECOG performance status (PS) 0 and low levels of CA 19–9 were associated with improved OS and PFS. Concerning OS, log(CA19–9) resulted in a hazard ratio (HR) of 1.20 (95% CI 1.02–1.42), p = 0.027. For ECOG PS 0, HR was 1.00; for PS 1, HR was 2.69 (95% CI 1.46–4.96); for PS 2, HR was 4.18 (95% CI 0.90–19.46); p = 0.003. Low CA19–9 levels were also predictive for resection, with an odds ratio of 0.71 (95% CI 0.52–0.97), p = 0.034. In conclusion, GEMOX and hypofractionated radiotherapy is a treatment option in LAPC. Further studies are needed to identify differences in tumor biology, which may help to predict resectability and prognosis. |
| Starting Page | 1200 |
| e-ISSN | 2218273X |
| DOI | 10.3390/biom11081200 |
| Journal | Biomolecules |
| Issue Number | 8 |
| Volume Number | 11 |
| Language | English |
| Publisher | MDPI |
| Publisher Date | 2021-08-12 |
| Access Restriction | Open |
| Subject Keyword | Biomolecules Oncology Radiology, Nuclear Medicine and Imaging Pancreatic Cancer Multimodal Treatment Gemox Tomotherapy |
| Content Type | Text |
| Resource Type | Article |
