NEOADJUVANT THERAPY FOR UNRESECTABLE PANCREATIC ADENOCARCINOMA

The purposes of this study were to determine whether continuous infusi on of fluorouracil combined with external-beam radiation therapy impro ved the resectability and survival of patients with pancreatic carcino ma. Sixteen patients with unresectable disease confined to the pancrea s and celiac nodes were treated, and their outcome was compared with t hat of 24 patients with potentially resectable disease who were treate d concurrently. The neoadjuvant therapy was completed with acceptably few toxic effects but with only a minor decrease in tumor size. Two pa tients underwent resection and remained free of disease 20 and 22.5 mo nths later. However, the median survival of the entire neoadjuvant gro up was 8 months. All 24 patients with potentially resectable carcinoma underwent surgical exploration. Fifteen of the 24 patients underwent resection and survived a median of 12.5 months. Neoadjuvant chemoradia tion may have improved outcome and resectability for two (12.5%) of 16 patients with unresectable pancreatic carcinoma, but more effective t herapy options must be developed to improve outcome.