Adding IORT to Intensive Neoadjuvant Chemo, CRT for Pancreatic Cancer

Share this content:
Adding intraoperative radiotherapy to intensive neoadjuvant chemotherapy and chemoradiotherapy yielded encouraging survival rates.
Adding intraoperative radiotherapy to intensive neoadjuvant chemotherapy and chemoradiotherapy yielded encouraging survival rates.

The addition of intraoperative radiotherapy (IORT) to intensive neoadjuvant chemotherapy and chemoradiotherapy was associated with encouraging survival rates without increased toxicity in patients with pancreatic adenocarcinoma who have close/positive margins and in those with unresectable disease, according to a study published in the American Journal of Clinical Oncology.1

The use of FOLFIRINOX (fluorouracil, leucovorin, irinotecan, oxaliplatin) or gemcitabine plus nab-paclitaxel has improved outcomes for patients with metastatic pancreatic adenocarcinoma, prompting incorporation of these regimens into neoadjuvant therapy of locally advanced unresectable disease.

Upon surgical exploration, some patients' tumors remain unresectable, while others are able to undergo resection of the tumor following intensive neoadjuvant therapy. Researchers therefore assessed the outcomes and safety associated with IORT in combination with resection or exploratory laparotomy after intensive neoadjuvant chemotherapy and chemoradiotherapy.

Investigators retrospectively analyzed data from 68 patients with locally advanced unresectable or borderline-resectable pancreatic adenocarcinoma who underwent intensive neoadjuvant induction chemotherapy and chemoradiotherapy followed by exploratory laparotomy and IORT.

Of those, 60.3% underwent resection, 26.5% had unresectable disease, and 13.2% had distant metastases. Of the 41 patients who underwent resection, 22 received IORT for close/positive resection margins.

RELATED: Second-line mFOLFOX6 and FU/LV for Pancreatic Cancer

The study showed no significant difference in median overall survival among patients who underwent resection, patients who underwent resection and IORT, and those who underwent resection alone; median overall survival was 26.6, 35.1, and 24.5 months, respectively.

A prospective study is needed to confirm these results and to determine the relationship between adding IORT and survival in this population.

Reference

  1. Keane FK, Wo JY, Ferrone CR, et al. Intraoperative radiotherapy in the era of intensive neoadjuvant chemotherapy and chemoradiotherapy for pancreatic adenocarcinoma. Am J Clin Oncol. 2016 Oct 12. doi: 10.1097/COC.0000000000000336 [Epub ahead of print]

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs

Sign Up for Free e-newsletters