Concurrent Nab-paclitaxel and Radiotherapy: Novel Radiosensitization for Borderline Resectable or Unresectable Pancreatic Cancer.
Aged
Aged, 80 and over
Albumins
/ adverse effects
Carcinoma, Pancreatic Ductal
/ drug therapy
Chemoradiotherapy
Deoxycytidine
/ analogs & derivatives
Female
Fluorouracil
/ therapeutic use
Humans
Male
Middle Aged
Paclitaxel
/ adverse effects
Pancreatic Neoplasms
/ drug therapy
Radiation-Sensitizing Agents
/ adverse effects
Treatment Outcome
Gemcitabine
Journal
American journal of clinical oncology
ISSN: 1537-453X
Titre abrégé: Am J Clin Oncol
Pays: United States
ID NLM: 8207754
Informations de publication
Date de publication:
01 09 2021
01 09 2021
Historique:
pubmed:
27
7
2021
medline:
21
9
2021
entrez:
26
7
2021
Statut:
ppublish
Résumé
This study evaluates the toxicity and tumor response with concurrent nab-paclitaxel chemoradiotherapy (CRT) compared with standard (5-fluorouracil or gemcitabine) CRT. Fifty patients with borderline resectable or unresectable pancreatic adenocarcinoma from 2014 to 2017 were divided into 2 groups: concurrent nab-paclitaxel (100 to 125 mg/m2 weekly) CRT (median: 2.1 Gy fraction size and 52.5 Gy total) or standard CRT (median: 1.8 Gy fraction size, 54.5 Gy total). The primary endpoint was toxicity, and secondary endpoints were local failure and conversion to resectability. Comparisons were made using rank-sum or Fisher exact test and multivariable competing risk regression for the cumulative incidence of local failure. There were 28 patients in the nab-paclitaxel CRT group and 22 in the standard CRT group; 88% had the unresectable disease. The median follow-up was 18 months. The median duration of chemotherapy before concurrent CRT was 1.9 and 2.3 months in the nab-paclitaxel and standard CRT groups (P=0.337), and radiotherapy dose was 52.5 Gy (range, 52.5 to 59.4 Gy) and 54.5 Gy (range, 45.0 to 59.4 Gy), respectively. There were no statistically significant grade ≥2 toxicities. The nab-paclitaxel CRT group experienced a nonstatistically significant lower incidence of local failure (hazard ratio=0.91, 95% confidence interval: 0.27-3.03, P=0.536). More patients in the nab-paclitaxel CRT group proceeded to surgery (9/28 compared with 3/22 in the standard CRT, P=0.186); of which 6 (25%) in the nab-paclitaxel CRT and 2 (10%) in the standard CRT groups were initially unresectable. Nab-paclitaxel CRT had similar toxicity compared with standard CRT in the treatment of borderline resectable or unresectable pancreatic cancer. Its use was associated with an arithmetically lower cumulative incidence of local failure and an arithmetically higher conversion to resectability, both of which were not statistically significant.
Identifiants
pubmed: 34310350
doi: 10.1097/COC.0000000000000854
pii: 00000421-202109000-00005
pmc: PMC8404955
doi:
Substances chimiques
130-nm albumin-bound paclitaxel
0
Albumins
0
Radiation-Sensitizing Agents
0
Deoxycytidine
0W860991D6
Paclitaxel
P88XT4IS4D
Fluorouracil
U3P01618RT
Gemcitabine
0
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
469-474Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
A.L.-B. reports personal fees from Celgene outside the submitted work. The other authors declare no conflicts of interest.
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