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• W2017825479 abstract "Purpose/Objective(s)Our phase I experience of neoadjuvant short course chemoradiation (SC-CRT) with proton radiation therapy (RT) and concurrent Capecitabine (Cape) for resectable pancreatic head adenocarcinoma (ACA) has been previously published and was found to be well tolerated. In this study, we sought to determine the feasibility and tolerability of SC-CRT for pancreatic ACA delivered with photon RT with concurrent Cape.Material/MethodsTen patients with localized, resectable pancreatic ACA were enrolled from December 2009 to August 2011. Patients received radiation with photon RT (IMRT or 3D conformal RT). In dose level I, patients received 3 Gy x 10 (Week 1 and 2, Monday-Friday, M-F). In dose level 2, patients received 5 Gy x 5 (Week 1 and 2, every other day, M-F). In dose level 3, patients received 5 Gy x 5 (Week 1, M-F). Cape was administered at 825 mg/m2 twice daily given during weeks 1 and 2 M-F for a total of 10 days. RT fields included the GTV and modest elective lymph node coverage. Surgery was performed 1-3 weeks after completion of chemotherapy. Adjuvant gemcitabine was recommended.ResultsThree patients were treated at Dose Level I and II, and 4 patients at Dose Level III. With an intended phase I accrual of 12 patients, the study was closed early due to unexpected intraoperative complications. One patient developed a dose-limiting toxicity (DLT) in Dose Level III. Seven patients developed 10 grade 3 toxicities (lymphopenia (2), elevated LFTs (2), hypophosphatemia (1), anorexia (1), nausea/emesis (1), diarrhea (1), infection (1), and hemorrhage (1)). Eight patients underwent resection (2 distal pancreatectomies, 6 Whipples). Reasons for no resection were metastatic (1 patient) and unresectable disease(1 patient). Compared to the companion phase I proton study, patients treated with photons had increased intraoperative RT fibrosis reported by surgeons (27% vs. 63%). Among those requiring Whipple, increased RT fibrosis translated to an increased mean operative time of 50 minutes, and increased post-operative length of stay (Table).ConclusionPoster Viewing Abstract 2314; TableSurgical outcomes of proton and photon studyProton studyCurrent study (Photon study)Number of surgically resected pts158Whipple resection15 (study eligibility criteria)6∗2 patients underwent distal pancreatectomy (excluded in the proton study)RT fibrosis4/15 (27%)5/8 (63%)Operative time†Whipple patients only5 hours 52 min6 hours 42 minLength of stay6 days10.4 daysPostoperative complications5/15 (33%)5/8 (63%)∗ 2 patients underwent distal pancreatectomy (excluded in the proton study)† Whipple patients only Open table in a new tab Purpose/Objective(s)Our phase I experience of neoadjuvant short course chemoradiation (SC-CRT) with proton radiation therapy (RT) and concurrent Capecitabine (Cape) for resectable pancreatic head adenocarcinoma (ACA) has been previously published and was found to be well tolerated. In this study, we sought to determine the feasibility and tolerability of SC-CRT for pancreatic ACA delivered with photon RT with concurrent Cape. Our phase I experience of neoadjuvant short course chemoradiation (SC-CRT) with proton radiation therapy (RT) and concurrent Capecitabine (Cape) for resectable pancreatic head adenocarcinoma (ACA) has been previously published and was found to be well tolerated. In this study, we sought to determine the feasibility and tolerability of SC-CRT for pancreatic ACA delivered with photon RT with concurrent Cape. Material/MethodsTen patients with localized, resectable pancreatic ACA were enrolled from December 2009 to August 2011. Patients received radiation with photon RT (IMRT or 3D conformal RT). In dose level I, patients received 3 Gy x 10 (Week 1 and 2, Monday-Friday, M-F). In dose level 2, patients received 5 Gy x 5 (Week 1 and 2, every other day, M-F). In dose level 3, patients received 5 Gy x 5 (Week 1, M-F). Cape was administered at 825 mg/m2 twice daily given during weeks 1 and 2 M-F for a total of 10 days. RT fields included the GTV and modest elective lymph node coverage. Surgery was performed 1-3 weeks after completion of chemotherapy. Adjuvant gemcitabine was recommended. Ten patients with localized, resectable pancreatic ACA were enrolled from December 2009 to August 2011. Patients received radiation with photon RT (IMRT or 3D conformal RT). In dose level I, patients received 3 Gy x 10 (Week 1 and 2, Monday-Friday, M-F). In dose level 2, patients received 5 Gy x 5 (Week 1 and 2, every other day, M-F). In dose level 3, patients received 5 Gy x 5 (Week 1, M-F). Cape was administered at 825 mg/m2 twice daily given during weeks 1 and 2 M-F for a total of 10 days. RT fields included the GTV and modest elective lymph node coverage. Surgery was performed 1-3 weeks after completion of chemotherapy. Adjuvant gemcitabine was recommended. ResultsThree patients were treated at Dose Level I and II, and 4 patients at Dose Level III. With an intended phase I accrual of 12 patients, the study was closed early due to unexpected intraoperative complications. One patient developed a dose-limiting toxicity (DLT) in Dose Level III. Seven patients developed 10 grade 3 toxicities (lymphopenia (2), elevated LFTs (2), hypophosphatemia (1), anorexia (1), nausea/emesis (1), diarrhea (1), infection (1), and hemorrhage (1)). Eight patients underwent resection (2 distal pancreatectomies, 6 Whipples). Reasons for no resection were metastatic (1 patient) and unresectable disease(1 patient). Compared to the companion phase I proton study, patients treated with photons had increased intraoperative RT fibrosis reported by surgeons (27% vs. 63%). Among those requiring Whipple, increased RT fibrosis translated to an increased mean operative time of 50 minutes, and increased post-operative length of stay (Table). Three patients were treated at Dose Level I and II, and 4 patients at Dose Level III. With an intended phase I accrual of 12 patients, the study was closed early due to unexpected intraoperative complications. One patient developed a dose-limiting toxicity (DLT) in Dose Level III. Seven patients developed 10 grade 3 toxicities (lymphopenia (2), elevated LFTs (2), hypophosphatemia (1), anorexia (1), nausea/emesis (1), diarrhea (1), infection (1), and hemorrhage (1)). Eight patients underwent resection (2 distal pancreatectomies, 6 Whipples). Reasons for no resection were metastatic (1 patient) and unresectable disease(1 patient). Compared to the companion phase I proton study, patients treated with photons had increased intraoperative RT fibrosis reported by surgeons (27% vs. 63%). Among those requiring Whipple, increased RT fibrosis translated to an increased mean operative time of 50 minutes, and increased post-operative length of stay (Table). ConclusionPoster Viewing Abstract 2314; TableSurgical outcomes of proton and photon studyProton studyCurrent study (Photon study)Number of surgically resected pts158Whipple resection15 (study eligibility criteria)6∗2 patients underwent distal pancreatectomy (excluded in the proton study)RT fibrosis4/15 (27%)5/8 (63%)Operative time†Whipple patients only5 hours 52 min6 hours 42 minLength of stay6 days10.4 daysPostoperative complications5/15 (33%)5/8 (63%)∗ 2 patients underwent distal pancreatectomy (excluded in the proton study)† Whipple patients only Open table in a new tab" @default.
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• W2017825479 date "2012-11-01" @default.
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• W2017825479 title "Phase I Study of Neoadjuvant Accelerated Short Course Radiation Therapy With Photons and Capecitabine for Resectable Pancreatic Cancer" @default.
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