摘要
AIM:To investigate the feasibility and efficacy of the combination of S-1 with gemcitabine followed by oral S-1 with concurrent radiotherapy(intensity modulated radiotherapy,IMRT) and maintenance therapy with S-1 for locally advanced pancreatic cancer.METHODS:Subjects selected in the study were patients who had unresectable and locally advanced pancreatic cancer without distant metastases,adequate organ and marrow functions,an Eastern Cooperative Oncology Group performance status of 0-1 and no prior anticancer therapy. Initially the subjects received two cycles of chemotherapy,oral administration of S-1 40 mg/m2 twice daily from day 1 to day 14 of a 21-d cycle,with 30-min intravenous infusions of gemcitabine 1000 mg/m2 on day 1 and day 8. Two weeks after the completion of chemotherapy,S-1 was administered orally with concurrent IMRT. Oral S-1 was administered at a dose of 80 mg/m2 per day twice daily from day 1 to day 14 and from day 22 to day 35. Radiation was concurrently delivered at a dose of 50.4 Gy(1.8 Gy/d,5 times per week,28 fractions). One month after the completion of chemotherapy and radiotherapy,S-1 was administered orally at a dose of 80 mg/m2 per day twice daily for 14 d,followed by a 14-d rest period. This cycle was repeated as maintenance therapy,until unacceptable toxicity occurred or the disease worsened. Thirty-two patients were involved in this study. The median followup was 15.6 mo(range:8.6-32.3 mo).RESULTS:Thirty-two patients completed the scheduled course of chemotherapy,while 30 patients(93.8%) received chemoradiotherapy with two patients ceasing to continue with radiotherapy. The major toxic effects were nausea and leukopenia. There was no grade 4 toxicity or treatment-related death. According to the Response Evaluation Criteria in Solid Tumors criteria,the objective tumor response was partial response in 17(53.1%) patients,stable disease in 9(28.1%),and progressive disease in 6(18.8%). The median overall survival and median progression-free survival were 15.2 mo and 9.3 mo,respectively. The survival rates at 1 year and 2 years were 75% and 34.4%,respectively.CONCLUSION:The combination of S-1 with gemcitabine followed by oral S-1 with IMRT and maintenance therapy with S-1 alone in patients with locally advanced pancreatic cancer may be considered a well-tolerated,promising treatment regimen.
AIM: To investigate the feasibility and efficacy of the combination of S-1 with gemcitabine followed by oral S-1 with concurrent radiotherapy (intensity modulated radiotherapy, IMRT) and maintenance therapy with S-1 for locally advanced pancreatic cancer.
