Kachnic L A, Shaw J E, Manning M A, Lauve A D, Neifeld J P
Gastrointestinal Tumor Center, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, USA.
Int J Cancer. 2001 Apr 20;96(2):132-9. doi: 10.1002/ijc.1008.
Gemcitabine has been shown to be an active agent in the treatment of pancreatic cancer. This study was conducted to prospectively examine the tolerance and early efficacy of adjuvant gemcitabine following radiotherapy with concurrent 5-fluorouracil (5-FU) for nonmetastatic pancreatic adenocarcinoma. Twenty-three patients, median age 64 years, were treated with combined modality therapy. Nine patients underwent tumor resection before chemoradiation; 14 patients with locally unresectable tumors received definitive chemoradiation. Radiotherapy utilized four fields to the tumor and lymphatics to 45 Gy, plus a lateral boost to 50.4 Gy. Concurrent 5-FU 500 mg/m(2)/day was administered on days 1-3 and 29-31, followed by 4 months of gemcitabine 1,000 mg/m(2)/week for 3 weeks (fourth week break). Adjuvant gemcitabine was well tolerated. Eighty-three percent of the patients completed three to four cycles. The primary dose-limiting toxicity was leukopenia, which was observed in 10 patients (43%). Nonhematologic toxicities were reported in five patients (22%). There were no cases of gemcitabine-induced radiation recall and there have been no deaths attributed to treatment toxicity. Median follow-up for the 23 patients was 12 months (range, 5-50); the actuarial median survival was 13 months. This report confirms that adjuvant gemcitabine following radiotherapy with concurrent 5-FU for nonmetastatic pancreatic adenocarcinoma can be safely administered.
吉西他滨已被证明是治疗胰腺癌的一种有效药物。本研究旨在前瞻性地检测在同步使用5-氟尿嘧啶（5-FU）进行放疗后辅助使用吉西他滨治疗非转移性胰腺腺癌的耐受性和早期疗效。23例患者，中位年龄64岁，接受了综合治疗。9例患者在放化疗前接受了肿瘤切除术；14例局部不可切除肿瘤患者接受了根治性放化疗。放疗采用四个野对肿瘤和淋巴结照射至45 Gy，外加侧野追加照射至50.4 Gy。在第1 - 3天和第29 - 31天同步给予5-FU 500 mg/m²/天，随后给予4个月的吉西他滨1000 mg/m²/周，共3周（第4周休息）。辅助使用吉西他滨耐受性良好。83%的患者完成了三到四个周期。主要剂量限制性毒性是白细胞减少，10例患者（43%）出现该情况。5例患者（22%）报告有非血液学毒性。没有吉西他滨引起的放射回忆病例，也没有因治疗毒性导致的死亡病例。23例患者的中位随访时间为12个月（范围5 - 50个月）；精算中位生存期为13个月。本报告证实，对于非转移性胰腺腺癌，在同步使用5-FU进行放疗后辅助使用吉西他滨可以安全给药。
