XXXX and efficacy of concurrent @entity136 and radiotherapy for locally advanced @entity788 .

@entity1 @entity788 @entity137 @entity5 @entity420 @entity3 @entity204 @entity136
BACKGROUND: @entity136 and radiotherapy are a potent combination. A clinical assessment of the therapeutic ratio for locally advanced @entity788 @entity1 has not yet been reported. AIM OF STUDY: To assess the @entity137 , survival, and pattern of failure of locally advanced @entity788 @entity1 treated with concurrent @entity136 -based chemoradiation. @entity1 and Methods. Between the dates of December 1996 and August 2000 51 @entity1 with locally advanced unresectable @entity420 were treated with concurrent @entity136 and radiotherapy at MDACC. @entity1 received 250-500 mg/m2 of @entity136 weekly x7 over 30 min and 30-33 Gy in 10-11 fractions over two weeks to the @entity5 and regional lymphatics. Severe @entity137 was defined as admission > 5 d, mucosal ulceration, > 3 dose deletions of @entity136 or @entity137 resulting in surgical intervention or that resulted in @entity204 . RESULTS: The median survival was 11 mo. Overall, 37 of 51 @entity1 had objective evidence of local progression. The actuarial rate of local progression rate at 9 mo was 70%. The 9-mo distant @entity3 rate was 52%. @entity5 > or = 10 cm2 had worse local control, distant control, and overall survival. Six @entity1 underwent pancreaticoduodenectomy after therapy. After review of the imaging, only four of these @entity1 had minimal arterial involvement, one was incorrectly staged, and one had initial inflammatory change on CT that resolved. Twelve of 51 (24%) @entity1 suffered severe acute @entity137 , and 17 of 51 (33%) @entity1 were admitted for supportive care. CONCLUSION: Concurrent @entity136 and radiotherapy can be a very difficult combination to administer safely. Our results do not suggest a prolongation of median survival for @entity1 with localized @entity788 treated with this therapy. It is possible that @entity136 -based chemoradiation contributes to the margin-negative resectability of a small number of @entity1 with minimal arterial involvement, but this benefit is obscured by the frequent @entity137 encountered in most @entity1 . Locally advanced @entity788 @entity1 should continue to be enrolled on prospective studies investigating novel combinations of cytotoxic and/or biologic agents with concurrent radiotherapy.
