Purpose: To determine the recommended dose of radiotherapy when combined with full-dose gemcitabine and erlotinib for unresected pancreas cancer.

Methods And Materials: Patients with unresected pancreatic cancer (Zubrod performance status 0-2) were eligible for the present study. Gemcitabine was given weekly for 7 weeks (1,000 mg/m(2)) with erlotinib daily for 8 weeks (100 mg). A final toxicity assessment was performed in Week 9. Radiotherapy (starting at 30 Gy in 2-Gy fractions, 5 d/wk) was given to the gross tumor plus a 1-cm margin starting with the first dose of gemcitabine. A standard 3 plus 3 dose escalation (an additional 4 Gy within 2 days for each dose level) was used, except for the starting dose level, which was scheduled to contain 6 patients. In general, Grade 3 or greater gastrointestinal toxicity was considered a dose-limiting toxicity, except for Grade 3 anorexia or Grade 3 fatigue alone.

Results: A total of 20 patients were treated (10 men and 10 women). Nausea, vomiting, and infection were significantly associated with the radiation dose (p = .01, p = .03, and p = .03, respectively). Of the 20 patients, 5 did not complete treatment and were not evaluable for dose-escalation purposes (3 who developed progressive disease during treatment and 2 who electively discontinued it). Dose-limiting toxicity occurred in none of 6 patients at 30 Gy, 2 of 6 at 34 Gy, and 1 of 3 patients at 38 Gy.

Conclusion: The results of the present study have indicated that the recommended Phase II dose is 30 Gy in 15 fractions.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijrobp.2010.08.050DOI Listing

Publication Analysis

Top Keywords

full-dose gemcitabine
8
gemcitabine erlotinib
8
erlotinib unresected
8
unresected pancreatic
8
pancreatic cancer
8
starting dose
8
dose level
8
dose-limiting toxicity
8
dose
7
patients
6

Similar Publications

Background: The National Comprehensive Cancer Network Bladder Cancer Guidelines recommend carboplatin and gemcitabine first-line treatment in patients with cisplatin-ineligible, metastatic urothelial cancer (mUC) -- a Category 1 recommendation. For these patients, the median overall survival is 9.3 months.

View Article and Find Full Text PDF
Article Synopsis
  • Older adults with diffuse large B-cell lymphoma (DLBCL) face unique challenges and poorer outcomes, highlighting the need for tailored care strategies.
  • Geriatric assessment (GA) tools, like simplified GA (sGA), help categorize patients into fit, unfit, and frail groups to guide treatment decisions, including dose adjustments for chemotherapy.
  • New treatment options, including CAR-T cell therapy and bispecific antibodies, are evolving to better serve older adults, particularly those who are unable to tolerate traditional therapies or who experience relapse after initial treatment.
View Article and Find Full Text PDF
Article Synopsis
  • * The study included 52 patients (mean age 75, 28 male and 24 female) who underwent NAC GS, with most having tumors located in the pancreatic head; however, only 2 patients completed full treatment due to necessary dose reductions.
  • * Adverse events were common, with 40.4% of patients experiencing significant neutropenia, but the treatment was generally manageable, resulting in 90.4% of patients undergoing successful R0 resection.
View Article and Find Full Text PDF

Background: According to current evidence, the best treatment for fit patients with non-resectable pancreatic cancer (PC) is combination chemotherapy, whereas frail patients are recommended gemcitabine (Gem) monotherapy. Randomized controlled trials in colorectal cancer and a post-hoc analysis of gemcitabine and nab-paclitaxel (GemNab) in PC suggest, however, that reduced dose of combination chemotherapy may be feasible and more efficient compared to monotherapy in frail patients. The aim of this study is to investigate whether reduced dose GemNab is superior to full dose Gem in patients with resectable PC, who are not candidates for full dose combination chemotherapy in first line.

View Article and Find Full Text PDF

Background: While gemcitabine/cisplatin (GC) is the gold standard regimen for patients with advanced urothelial carcinoma (aUC), either dose-reduced GC or gemcitabine/carboplatin (GCa) is an alternative option for "cisplatin-unfit" patients. However, few studies have compared outcomes with these commonly used regimens in the real-world setting.

Methods: We retrospectively reviewed patients with aUC who received full-dose GC, dose-reduced GC, or GCa as first-line salvage chemotherapy at two university hospitals between 2016 and 2020.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!