Preoperative chemoradiotherapy for stage I-III adenocarcinoma of the pancreas: The Fox Chase Cancer Center experience with 63 patients

SINCE 1987, 63 patients with cancer of the pancreas have been treated at Fox Chase Cancer Center with preoperative radiotherapy (1,060-6,300 cGy, median 5,040 cGy) combined with 5-fluorouracil (1,000 mg/m²/day, days 2 to 5 and 29 to 32) and mitomycin C (10 mg/m², day 2). Four of the 29 resections were palliative (3 pancreatectomy plus liver metastasectomy, one hepatic artery and superior mesenteric vein resection and replacement) and 25 (40% of the entire series, 50% of those having surgery) were potentially curative. One patient with a palliative and one with a potentially curative resection died postoperatively. Two patients had severe complications after surgery. Seventeen (68%) of the 25 patients with potentially curative resections have developed recurrent disease, but only 4 have had a local component to that recurrence. Median survival of the 11 patients with potentially curative resections from the pilot series is 45 months. Follow-up of these 11 patients ranges from 17 to 73 months (median, 36 months).