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(Locally advanced unresectable pancreatic cancer: Induction chemoradiotherapy followed by maintenance gemcitabine versus gemcitabine alone: Definitive results of the 2000-2001 FFCD/SFRO phase III trial).
Barhoumi M., Mornex F., Bonnetain F., Rougier P., Mariette C. et al
Cancer Radiothérapie 15, 3 (2011) 182-191 - http://hal.archives-ouvertes.fr/hal-00719146
Sciences du Vivant/Cancer
[Locally advanced unresectable pancreatic cancer: Induction chemoradiotherapy followed by maintenance gemcitabine versus gemcitabine alone: Definitive results of the 2000-2001 FFCD/SFRO phase III trial].
M. Barhoumi1, F. Mornex, Franck Bonnetain, P. Rougier, C. Mariette2, O. Bouché, J.-F. Bosset3, T. Aparicio, L. Mineur, A. Azzedine, P. Hammel, J. Butel, N. Stremsdoerfer, P. Maingon, L. Bedenne, B. Chauffert
1 :  Laboratoire d'Epidémiologie et d'Ecologie parasitaire, Institut Pasteur de Tunis
Institut Pasteur de Tunis – Réseau International des Instituts Pasteur
Tunisie
2 :  GANIL - Grand Accélérateur National d'Ions Lourds
http://www.ganil-spiral2.eu
CNRS : UPR3266 – IN2P3 – CEA : DSM/GANIL
Bvd Henri Becquerel - BP 55027 - 14076 CAEN CEDEX 5
France
3 :  CEF2P - Carcinogénèse épithéliale : facteurs prédictifs et pronostiques
Université de Franche-Comté : EA3181 – CHU Besançon – IFR133
Les hauts de chazal - bât. Recherche - rue Ambroise Paré - 25000 BESANCON
France
PURPOSE: To compare chemoradiation with systemic chemotherapy to chemotherapy alone in locally advanced pancreatic cancer. PATIENTS AND METHODS: One hundred and nineteen patients with locally advanced pancreatic cancer, with World Health Organization performance status of zero to two were randomly assigned to either the induction chemoradiation group (60 Gy, 2 Gy/fraction; concomitant 5-fluoro-uracil infusion, 300 mg/m(2) per day, days 1-5 for 6 weeks; cisplatin, 20 mg/m(2) per day, days 1-5 during weeks 1 and 5) or the induction gemcitabine group (GEM: 1000 mg/m(2) weekly for 7 weeks). Maintenance gemcitabine (1000 mg/m(2) weekly, 3/4 weeks) was given in both arms until disease progression or toxicity. RESULTS: Overall survival was shorter in the chemoradiation than in the gemcitabine arm (median survival 8.6 [99% confidence interval 7.1-11.4] and 13 months [8,9,9-18], p=0.03). One-year survival was, respectively, 32 and 53%. These results were confirmed in a per-protocol analysis for patients who received 75% or more of the planned dose of radiotherapy. More overall grades 3-4 toxic effects were recorded in the chemoradiation arm, both during induction (36 versus 22%) and maintenance (32 versus 18%). CONCLUSION: This intensive induction schedule of chemoradiation was more toxic and less effective than gemcitabine alone.
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Cancer Radiothérapie (Cancer Radiother)
Publisher Elsevier
ISSN 1278-3218 
internationale
Articles dans des revues avec comité de lecture
06/2011
10/02/2011
15
3
182-191

Adult – Aged – 80 and over – Antimetabolites – Antineoplastic – Antineoplastic Combined Chemotherapy Protocols – Carcinoma – Pancreatic Ductal – Cisplatin – Combined Modality Therapy – Deoxycytidine – Disease Progression – Female – Fluorouracil – Gastrointestinal Diseases – Hematologic Diseases – Humans – Kaplan-Meier Estimate – Male – Middle Aged – Pancreatic Neoplasms – Proportional Hazards Models – Radiotherapy – Conformal – Remission Induction