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Preoperative FOLFIRINOX for borderline resectable pancreatic cancer: Is radiation necessary in the modern era of chemotherapy?
- Source :
- Journal of Surgical Oncology. 114:587-596
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- Background No consensus exists regarding the optimal neoadjuvant treatment paradigm for patients with borderline resectable pancreatic cancer (BRPC), including the respective roles of chemotherapy and radiation. Methods We performed a retrospective analysis, including detailed pathologic and radiologic review, of pancreatic cancer patients undergoing FOLFIRINOX, with or without radiation therapy (RT), prior to surgical resection at a high-volume academic center over a 4-year period. Results Of 26 patients meeting inclusion criteria, 22 (84.6%) received FOLFIRINOX alone without RT (median number of treatment cycles = 9). The majority of patients met formal radiographic criteria for BRPC, with the superior mesenteric vein representing the most common vessel involved. R0 resection rate was 90.9%, with 12 patients (54.5%) requiring vascular reconstruction. Treatment response was classified as moderate or marked in 16 patients (72.7%) according to the College of American Pathologists grading system. Estimated median disease-free and overall survival rates are 22.6 months and not reached (NR), respectively. Conclusions This is one of the largest series to describe the use of neoadjuvant FOLFIRINOX, without radiation therapy, in patients with BRPC undergoing surgical resection. Given the high R0 resection rates and favorable clinical outcomes with chemotherapy alone, this strategy should be further assessed in prospective study design. J. Surg. Oncol. 2016;114:587–596. © 2016 Wiley Periodicals, Inc.
- Subjects :
- medicine.medical_specialty
business.industry
FOLFIRINOX
medicine.medical_treatment
Retrospective cohort study
General Medicine
medicine.disease
Preoperative care
Surgery
Radiation therapy
03 medical and health sciences
0302 clinical medicine
Oncology
030220 oncology & carcinogenesis
Pancreatic cancer
Pancreatectomy
medicine
030211 gastroenterology & hepatology
business
Prospective cohort study
Neoadjuvant therapy
Subjects
Details
- ISSN :
- 00224790
- Volume :
- 114
- Database :
- OpenAIRE
- Journal :
- Journal of Surgical Oncology
- Accession number :
- edsair.doi...........fa6358c6416941567c7f707e25223e12