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Adjuvant intra-arterial 5-fluoruracil, leucovorin, epirubicin and carboplatin with or without systemic gemcitabine after curative resection for pancreatic adenocarcinoma.
- Source :
-
Cancer chemotherapy and pharmacology [Cancer Chemother Pharmacol] 2006 Oct; Vol. 58 (4), pp. 504-8. Date of Electronic Publication: 2006 Apr 22. - Publication Year :
- 2006
-
Abstract
- Background: The role of adjuvant therapy in pancreatic cancer remains controversial. Gemcitabine given systemically seems to be effective; intra-arterial chemotherapy (IAC) has a deep rationale.<br />Patients and Methods: The goal was to evaluate the impact of postoperative IAC followed or not by systemic gemcitabine in patients after curative resection for pancreatic adenocarcinoma. 5-fluoruracil 750 mg sq m(-1), leucovorin 75 mg sq m(-1), epirubicin 45 mg sq m(-1), carboplatin 225 mg sq m(-1) were administered every 3 weeks into celiac axis for three cycles (FLEC regimen), then gemcitabine at the dosage of 1 g sq m(-1) on days 1, 8 and 15 every 4 weeks for 3 months (FLECG regimen).<br />Results: Forty-seven patients entered the study. The first 24 received only IAC (FLEC regimen), the other 23 received the same intra-arterial regimen followed by systemic gemcitabine (FLECG regimen). After a median follow-up of 16.9 months, 29 patients recurred (61.7%). Median disease free survival (DFS) was 18 months and median overall survival (OS) was 29.7 months. One-year DFS was 59.4% and 1-year OS was 75.5%. Main grade 3 toxicity related to IAC was only nausea/vomiting in 4%; regarding gemcitabine, grade 3 toxicities were anaemia 8%, leukopenia 8%, thrombocitopenia 17%, nausea/vomiting 4%.<br />Conclusions: FLEC regimen with or without gemcitabine is active with a very mild toxicity and results are very encouraging in an adjuvant setting.
- Subjects :
- Adenocarcinoma mortality
Adenocarcinoma surgery
Adult
Aged
Antimetabolites, Antineoplastic administration & dosage
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Carboplatin administration & dosage
Carboplatin therapeutic use
Chemotherapy, Adjuvant
Deoxycytidine administration & dosage
Deoxycytidine therapeutic use
Disease-Free Survival
Epirubicin administration & dosage
Epirubicin therapeutic use
Female
Fluorouracil administration & dosage
Fluorouracil therapeutic use
Humans
Infusions, Intra-Arterial
Karnofsky Performance Status
Leucovorin administration & dosage
Leucovorin therapeutic use
Male
Middle Aged
Pancreatic Neoplasms mortality
Pancreatic Neoplasms surgery
Gemcitabine
Adenocarcinoma drug therapy
Antimetabolites, Antineoplastic therapeutic use
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Deoxycytidine analogs & derivatives
Pancreatic Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0344-5704
- Volume :
- 58
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Cancer chemotherapy and pharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 16633830
- Full Text :
- https://doi.org/10.1007/s00280-006-0200-2