Background & objective: Radiotherapy and chemotherapy are major therapies for locally advanced pancreatic cancer. This study was to evaluate the efficacy of three-dimensional conformal gamma-knife radiotherapy combined with thermochemotherapy on locally advanced pancreatic cancer.
Methods: From December 2001 to January 2006, 75 patients with locally advanced pancreatic cancer were divided into radiotherapy group (37 patients) and combination group (38 patients). All patients received gamma-knife radiotherapy using Stereotactic Radiotherapy Gamma Rays System, with iso-dose curves of 50%-60%, tumor encircling dose of 3.0-4.5 Gy per fraction, 8-11 fractions. The patients in combination group received simultaneous thermotherapy at 41.5-43.5 celsius (1 h/fraction, twice a week for 6 times), and chemotherapy with venous administration of tegafur (0.5-1.0 g) and calcium folinate (CF, 0.2 g) for 4-6 times, or venous administration of gemcitabine (0.6-1.0 g/m2) on Days 1 and 8 and cisplatin (DDP) (20-30 mg/m2) on Days 1-3, repeated every 28 days for 3-6 cycles.
Results: At 3 months after treatment, the total response (complete remission and partial remission) rate was 70.7% (53/75); the response rate was 73.7% in combination group and 67.5% in radiotherapy group. The 1-year survival rate was 48.3%, and the 2-year survival rate was 22.1%. The 1-and 2-year survival rates were 51.2% and 26.5% in combination group, and 45.2% and 17.6% in radiotherapy group. No serious complications, such as perforation, bleeding and high fever, were seen during treatment and follow-up.
Conclusion: 3-D conformal gamma-knife radiotherapy combined with thermochemotherapy is well tolerated and is relatively effective for most patients with locally advanced pancreatic cancer.