International Journal of Radiation Oncology * Biology * Physics
Volume 72, Issue 4 , Pages 1128-1133 , 15 November 2008

Neoadjuvant Radiation Is Associated With Improved Survival in Patients With Resectable Pancreatic Cancer: An Analysis of Data From the Surveillance, Epidemiology, and End Results (SEER) Registry

  • Alexander M. Stessin, B.S.

      Affiliations

    • Tri-Institutional M.D.–Ph.D. Program, New York, NY
    • Weill Medical College of Cornell University, New York, NY
    • ,
  • Joshua E. Meyer, M.D.

      Affiliations

    • New York Presbyterian Hospital, New York, NY
    • ,
  • David L. Sherr, M.D.

      Affiliations

    • New York Presbyterian Hospital, New York, NY
    • Corresponding Author InformationReprint requests to: David Sherr, M.D., Stich Radiation Oncology Center, Weill Cornell Medical College, 525 East 68th Street, Box 575, New York, NY 10065. Tel: (212) 746-3614; Fax: (212) 746-8749

Received 4 September 2007 ,Revised 25 February 2008 ,Accepted 26 February 2008.

References 

  1. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin. 2006;56:106–130
  2. Li D, Xie K, Wolff R, et al. Pancreatic cancer. Lancet. 2004;363:1049–1057
  3. Steer ML. Exocrine pancreas. In:  Townsend CM editors. Sabiston textbook of surgery: The biological basis of modern surgical practice. 17th ed.. Philadelphia, PA: Elsevier; 2004;p. 1671
  4. Geer RJ, Brennan MF. Prognostic indicators of survival after resection of pancreatic adenocarcinoma. Am J Surg. 1993;165:68–72
  5. Nitecki SS, Sarr MG, Colby TV, et al. Long term survival after resection for ductal adenocarcinoma of the pancreas. Is it really improving?. Ann Surg. 1995;221:59–66
  6. Sohn TA, Yeo CJ, Cameron JL, et al. Resected adenocarcinoma of the pancreas. 616 Patients: Results, outcomes, and prognostic indicators. J Gastrointest Surg. 2000;4:567–579
  7. Sperti C, Pasquali C, Piccoli A, et al. Recurrence after resection for ductal adenocarcinoma of the pancreas. World J Surg. 1997;21:195–200
  8. Moertel CG, Childs DS, Reitermeier RJ. Combined 5-fluorouracil and supervoltage radiation therapy of locally unresectable cancer. Lancet. 1969;2:865–867
  9. Neoptolemos JP, Cunningham D, Friess H, et al. Adjuvant therapy in pancreatic cancer: Historical and current perspective. Ann Oncol. 2003;14:675–692
  10. Wilkowski R, Heinemann V, Rau H. Radio-chemotherapy including gemcitabine and 5-fluorouracil for treatment of locally advanced pancreatic cancer. Proc Am Soc Clin Oncol. 2000;19:1078
  11. Kalser MH, Ellenberg SS. Pancreatic cancer. Adjuvant combined radiation and chemotherapy following curative resection. Arch Surg. 1985;120:899–903
  12. Neoptolemos JP, Kerr DJ, Beger H. ESPAC-1 trial progress report; the European adjuvant study comparing radiochemotherapy, 6 months chemotherapy and combination therapy vs. observation in pancreatic cancer. Digestion. 1997;58:570–577
  13. Neoptolemos JP, Stocken DD, Friess H, et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med. 2004;350:1200–1210
  14. Breslin TM, Hess KR, Harbison DB, et al. Neoadjuvant chemoradiotherapy for adenocarcinoma of the pancreas: Treatment variables and survival duration. Ann Surg Oncol. 2001;8:123–132
  15. White RR, Xie HB, Gottfried MR, et al. Significance of histological response to preoperative chemoradiotherapy for pancreatic cancer. Ann Surg Oncol. 2005;12:214–221
  16. Sasson AR, Wetherington RW, Hoffman JP, et al. Neoadjuvant chemoradiotherapy for adenocarcinoma of the pancreas: Analysis of histopathology and outcome. Int J Gastrointest Cancer. 2003;34:121–128
  17. Snady H, Bruckner H, Cooperman A, et al. Survival advantage of combined chemoradiotherapy compared with resection as the initial treatment of patients with regional pancreatic carcinoma. An outcomes trial. Cancer. 2000;89:314–327
  18. Hazard L, Tward JD, Szabo A, et al. Radiation therapy is associated with improved survival in patients with pancreatic adenocarcinoma: Results of a study from the Surveillance, Epidemiology, and End Results (SEER) Registry data. Cancer. 2007;110:2191–2201
  19. Pisters PW, Abbruzzesse JL, Janian NA, et al. Rapid-fractionation preoperative chemoradiation, pancreaticoduodenectomy, and intraoperative radiation therapy for resectable pancreatic adenocarcinoma. J Clin Oncol. 1998;16:3843–3850
  20. Pisters PW, Wolff RA, Janian NA, et al. Preoperative paclitaxel and concurrent rapid-fractionation radiation for resectable pancreatic adenocarcinoma: Toxicities, histologic response rates, and event-free outcome. J Clin Oncol. 2002;20:2537–2514
  21. Wolff RA, Evans DB, Crane CH, et al. Initial results of preoperative gemcitabine(GEM)-based chemoradiation for resectable pancreatic adenocarcinoma. [Abstract] Proc Am Soc Clin Oncol. 2002;21:516
  22. Mornex F, Girard N, Scoazec JY, et al. Feasibility of preoperative combined radiation therapy and chemotherapy with 5-fluorouracil and cisplatin in potentially resectable pancreatic adenocarcinoma. The French SFRO-FFCD 97-04 Phase II trial. Intl J Radiat Oncol Biol Phys. 2006;65:1471–1478
  23. Talamonti MS, Small W, Mulcahy MF, et al. A multi-institutional phase II trial of preoperative full-dose gemcitabine and concurrent radiation for patients with potentially resectable pancreatic carcinoma. Ann Surg Oncol. 2006;13:150–158
  24. Wilkowski R, Thoma M, Schauer R, et al. Effect of chemoradiotherapy with gemcitabine and cisplatin on locoregional control in patients with primary inoperable pancreatic cancer. World J Surg. 2004;10:1011–1018
  25. Wayne JD, Wolff RA, Pisters PW, et al. Multimodality management of localized pancreatic cancer. Cancer J. 2001;7(Suppl 1):S35–S46
  26. Turrini O, Moutardier V, Guitamand J, et al. Hemorrhage after duodenopancreatectomy: Impact of neoadjuvant radiochemotherapy and experience with sentinel bleeding. World J Surg. 2005;29:212–216
  27. Pilepich MV, Miller HH. Preoperative irradiation in carcinoma of the pancreas. Cancer. 1980;46:1945–1949
  28. Ishikawa O, Ohigashi H, Teshima T, et al. Clinical and histopathological appraisal of preoperative irradiation for adenocarcinoma of the pancreaticoduodenal region. J Surg Oncol. 1989;40:143–151
  29. Partensky C, Maddern G. Pancreatectomy after neoadjuvant chemoradiotherapy for potentially resectable exocrine adenocarcinoma of the pancreas. Cancer Radiother. 1998;2:771–774
  30. Cheng TY, Sheth K, White RR, et al. Effect of neoadjuvant chemoradiation on operative mortality and morbidity for pancreaticoduodenectomy. Ann Surg Oncol. 2006;13:66–74
  31. Ishikawa O, Ohigashi H, Imaoka S, et al. Is the long-term survival rate improved by preoperative irradiation before Whipple's procedure for adenocarcinoma of the pancreatic head?. Arch Surg. 1994;129:1075–1080
  32. Kim R, Saif MW. Is there an optimal neoadjuvant therapy for locally advanced pancreatic cancer?. J Pancreas. 2007;8:279–288

 Presented at the 49th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO), October 29–November 1, 2007, Los Angeles, CA.

 Conflict of interest: none.

PII: S0360-3016(08)00421-5

doi: 10.1016/j.ijrobp.2008.02.065

International Journal of Radiation Oncology * Biology * Physics
Volume 72, Issue 4 , Pages 1128-1133 , 15 November 2008

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