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Regional hyperthermia combined with chemoradiotherapy in primary or recurrent locally advanced pancreatic cancer

An Open-Label Comparative Cohort Trial

Regionale Hyperthermie kombiniert mit Chemoradiotherapie bei Erstdiagnose oder Rezidiv eines primären oder rezidivierten lokal fortgeschrittenen Pankreaskarzinoms: eine offene Kohortenvergleichsstudie

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Purpose

To evaluate the therapeutic effect of delivering regional hyperthermia (HT) plus chemoradiotherapy (CRT) in patients suffering from locally advanced unresectable pancreatic cancer (LAPC).

Methods

Between January 2000 and December 2008, 68 patients affected by primary (56/68) or recurrent (12/68) LAPC were treated either with CRT alone or CRT plus HT. Radiotherapy (RT) consisted of 3D conformal irradiation of tumor and regional lymph nodes (dose ranged from 30 Gy/10 fractions to 66 Gy/33 fractions). Chemotherapy (CT) consisted of gemcitabine (GEM) alone or in association with either oxaliplatin, cisplatin, or 5-FU. HT was delivered twice a week, concomitant with RT.

Results

In the current study, 60 of the original 68 patients were included. Median overall survival (OS) was 15 months in the HT group versus 11 months in the control group (log-rank test: p = 0.025). HT did not increase CRT toxicity.

Conclusion

HT can be added safely to CRT in LAPC, thus, resulting in slightly prolonged survival in certain cases.

Ziel

Die Evaluierung des therapeutischen Effekts der regionalen Hyperthermie (HT), kombiniert mit Chemoradiotherapie (CRT) bei Patienten mit einem lokal fortgeschrittenen, nicht resektablen Pankreaskarzinom (LAPC).

Methoden

Zwischen Januar 2000 und Dezember 2008 wurden 68 Patienten mit Erstdiagnose (56/68) oder Rezidiv (12/68) eines LAPC mit CRT alleine oder mit CRT in Kombination mit HT behandelt. Die RT wurde in Form einer 3D-konformalen Strahlentherapie appliziert. Das Zielvolumen umfasste den Tumor sowie die regionalen Lymphknoten (Dosis-Range von 30 Gy/10 Fraktionen bis zu 66 Gy/33 Fraktionen). Die Chemotherapie (CT) erfolgte mit Gemcitabin (GEM) alleine oder in Kombination mit Oxaliplatin, Cisplatin oder 5-FU. HT wurde zweimal wöchentlich in Kombination mit der RT appliziert.

Ergebnisse

60 von 68 Patienten konnten evaluiert werden. Das mediane Überleben (OS) war 15 Monate in der HAT-Gruppe versus 11 Monate in der Kontrollgruppe (Log- rank-Test: p = 0,025). Der Zusatz einer HT führt zu keiner Erhöhung der Nebenwirkungen der CRT.

Schlussfolgerung

Die HT kann ohne Bedenken einer CRT bei LAPC hinzugefügt werden und ermöglicht in bestimmten Fällen das OS zu verlängern.

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Authors and Affiliations

  1. Department of Radiotherapy, University Hospital, Verona, Italy

    Sergio Maluta, Fabio Pioli, Stefano Dall’Oglio & Stefano Pasetto

  2. Department of Oncology, Ziv Medical Center and School of Medicine, Zefat, Israel

    Moshe Schaffer MD, PhD

  3. Bad Trissl Oncology Hospital, Oberaudorf, Germany

    Pamela M. Schaffer & Bernard Weber

  4. Department of Health Physics, University Hospital, Verona, Italy

    Maria Grazia Giri

  5. Department of Oncology, Ziv Medical Center and School of Medicine, Rambam Str, Zefat, Israel

    Moshe Schaffer MD, PhD

Authors
  1. Sergio Maluta
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Correspondence to Moshe Schaffer MD, PhD.

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Maluta, S., Schaffer, M., Pioli, F. et al. Regional hyperthermia combined with chemoradiotherapy in primary or recurrent locally advanced pancreatic cancer. Strahlenther Onkol 187, 619–625 (2011). https://doi.org/10.1007/s00066-011-2226-6

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  • DOI: https://doi.org/10.1007/s00066-011-2226-6

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