Lack of effectiveness of radiotherapy combined with cisplatin in patients with locally advanced pancreatic carcinoma

BACKGROUND. Cisplatin has been reported to enhance the cell-killing effect of radiation. The current study was conducted to evaluate the efficacy and toxicity of radiotherapy combined with cisplatin in patients with locally a dvanced pancreatic carcinoma. METHODS. Forty-one patients with pancreatic carcinoma that was unresectable but confined to the pancreatic region were treated with external beam radi ation (50.4 grays [Gy] in 28 fractions over 5.5 weeks) and daily cisplatin (5 mg/m(2)/day as a 30-minute infusion just before each radiation fraction) . Maintenance 5-fluorouracil (5-FU) (500 mg/m(2)) given once weekly was ini tiated 1 week after the completion of the chemoradiotherapy and continued u ntil disease progression or unacceptable toxicity. RESULTS. Of the 41 patients, 31 (76%) completed the scheduled course of che moradiotherapy. The median survival time was 7.7 months, and the 1-year sur vival rate was 36%. The median progression free survival time was 5.8 month s. The first site of failure was distant metastases in 25 patients, locoreg ional recurrence in 6 patients, and both sites in 1 patient. The major toxi city was leukocytopenia and nausea/emesis. CONCLUSIONS. Radiotherapy with daily cisplatin appears to be inferior to co nventional chemoradiotherapy using 5-FU in patients with locally advanced p ancreatic carcinoma. (C) 2001 American Cancer Society.