Adjuvant chemoradiotherapy in XXXX - Where does it stand with conformal radiotherapy: A single institution experience.

@entity1 @entity901 @entity137 @entity66 @entity5 @entity74 @entity136
BACKGROUND: Treatment of @entity5 involves Whipple surgery, followed by adjuvant radiotherapy and chemotherapy. Postoperative radiotherapy is particularly useful in managing high-risk @entity1 ( @entity5 involving the pancreas, poorly differentiated histology, involved lymph nodes and positive margins). Here, we review our results of treatment of 84 @entity1 treated by surgery and adjuvant radiotherapy and chemotherapy. MATERIAL AND METHODS: A retrospective analysis of 84 @entity1 of @entity5 treated in our department between January 2007 and December 2012 was carried out. All @entity1 underwent Whipples surgery followed by postoperative radiotherapy 45-50 Gy/25-28 number in those presenting with high-risk features. Radiotherapy was delivered using three-dimensional conformal technique with 6 MV photons using three field treatment plans. Chemotherapy was given for 6 cycles using @entity136 and @entity901 regimen repeated 2 weekly. RESULTS: Eighty four postoperative @entity1 with high-risk features were available for the final analysis. There were 69 males and 15 female @entity1 . There were 34.5% stage I, 57.1% stage II and 8.3% stage III @entity1 . At end of adjuvant treatment with radiotherapy and chemotherapy 70% @entity1 had a complete response, 7.5% had @entity66 , 15% showed @entity74 , 5% were dead and 2.5% defaulted the treatment. The mean number of chemotherapy cycles received was 2.6. At 1 year follow-up the probability of disease free survival was 80% for node-negative @entity1 versus 73% for node-positive disease (P = 0.27). @entity1 with stage up to IIA had a 1 year disease free survival of 83% versus 40% for @entity1 with stage beyond IIA (P = 0.024). CONCLUSIONS: Our results showed a trend favoring lymph node negative status with disease free survival. With computed tomography based planning, adequate delineation of draining nodes is possible, and @entity137 has significantly decreased. Adequate coverage of nodal basins during radiotherapy planning is important, and stage of the disease seems to be an important prognostic factor.
