Initial systemic chemotherapy ( 6 months ) with a combination regimen is recommended for most patients ( for some patients radiation therapy may be offered up front ) with Eastern Cooperative Oncology Group performance status 0 or 1 and a favorable comorbidity profile .
There is no clear evidence to support one regimen over another .
PURPOSE To provide evidence -based recommendations to oncologists and others for treatment of patients with locally advanced , unresectable pancreatic cancer .
Phase I study of stereotactic radiosurgery in patients with locally advanced pancreatic cancer.
PURPOSE To determine the feasibility and toxicity of delivering stereotactic radiosurgery to patients with locally advanced pancreatic cancer . METHODS AND MATERIAL S Patients with Eastern Cooperative Oncology Group performance status < or=2 and locally advanced pancreatic cancer were enrolled on this Phase I dose escalation study . Patients received a single fraction of radiosurgery consisting of either 15 Gy , 20 Gy , or 25 Gy to the primary tumor . Acute gastrointestinal toxicity was scored according to the Radiation Therapy Oncology Group criteria . Response to treatment was determined by serial high-resolution computed tomography scanning . RESULTS Fifteen patients were treated at 3 dose levels ( 3 patients received 15 Gy , 5 patients received 20 Gy , and 7 patients received 25 Gy ) . At these doses , no Grade 3 or higher acute gastrointestinal toxicity was observed . This trial was stopped before any dose-limiting toxicity was reached , because the clinical objective of local control was achieved in all 6 evaluable patients treated at 25 Gy . CONCLUSIONS It is feasible to deliver stereotactic radiosurgery to patients with locally advanced pancreatic cancer . The recommended dose to achieve local control without significant acute gastrointestinal toxicity is 25 Gy
Initial systemic chemotherapy ( 6 months ) with a combination regimen is recommended for most patients ( for some patients radiation therapy may be offered up front ) with Eastern Cooperative Oncology Group performance status 0 or 1 and a favorable comorbidity profile .
There is no clear evidence to support one regimen over another .
PURPOSE To provide evidence -based recommendations to oncologists and others for treatment of patients with locally advanced , unresectable pancreatic cancer .