Pancreatic cancer: treatment with neutron irradiation alone and with chemotherapy

• Published in: Radiology Vol. 200; no. 3; p. 627
• Main Authors: Cohen, L, Hendrickson, F R, Lennox, A J, Kroc, T K, Hatcher, M A, Bennett, B R
• Format: Journal Article
• Language: English
• Published: United States 01.09.1996
• Subjects: Actuarial Analysis; Adenocarcinoma - complications; Adenocarcinoma - drug therapy; Adenocarcinoma - mortality; Adenocarcinoma - radiotherapy; Adult; Aged; Antimetabolites, Antineoplastic - administration & dosage; Chemotherapy, Adjuvant - adverse effects; Female; Fluorouracil - administration & dosage; Follow-Up Studies; Humans; Male; Middle Aged; Neutrons - adverse effects; Neutrons - therapeutic use; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - drug therapy; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - radiotherapy; Radiotherapy Dosage; Treatment Outcome
• ISSN: 0033-8419
• DOI: 10.1148/radiology.200.3.8756907

To evaluate neutron irradiation alone and with chemotherapy to treat inoperable pancreatic cancer. Between 1977 and 1994, 173 patients (60 men, 113 women, aged 43-77 years [mean, 59 years]) with unresectable adenocarcinoma of the exocrine pancreas were treated, 106 with neutron irradiation alone and 67 with concomitant chemotherapy (fluorouracil [5-FU]). At follow-up, which was performed at 2-month intervals until death (range, 4-64 months), clinical status was recorded, noting the presence of overt metastasis and the onset of any major complications. Actuarial (Kaplan-Meier) survival tables were computed for both groups. For neutron irradiation alone and neutron irradiation plus chemotherapy, median survival times were 6 months and 9 months, respectively; actuarial survival rates at 3 years were 0 and 7%, respectively; major reactions (grade 3 or higher [scale of the Radiation Therapy Oncology Group and European Organization for Research and Treatment of Cancer]) occurred in 19 (18%) and 17 (25%) patients, respectively; and severe complications (grade 4) occurred in five (5%) and four (6%) patients, respectively. Most deaths were due to metastatic disease rather than to failure of local control. Neutron irradiation obliterated pancreatic adenocarcinoma at the primary site but has no effect on long-term survival. With more effective concomitant chemotherapy to prevent metastasis, local control of pancreatic cancer with neutron irradiation could lead to increased long-term survival.