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Pancreatic Neoplasms: HELP
Articles by Barry Iacopetta
Based on 1 article published since 2008
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Between 2008 and 2019, Barry Iacopetta wrote the following article about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Clinical Trial 3D radiotherapy can be safely combined with sandwich systemic gemcitabine chemotherapy in the management of pancreatic cancer: factors influencing outcome. 2008

Spry, Nigel / Harvey, Jennifer / Macleod, Craig / Borg, Martin / Ngan, Samuel Y / Millar, Jeremy L / Graham, Peter / Zissiadis, Yvonne / Kneebone, Andrew / Carroll, Susan / Davies, Terri / Reece, William H H / Iacopetta, Barry / Goldstein, David. ·Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia. Nigel.Spry@health.wa.gov.au ·Int J Radiat Oncol Biol Phys · Pubmed #18164859.

ABSTRACT: PURPOSE: The aim of this Phase II study was to examine whether concurrent continuous infusion 5-fluorouracil (CI 5FU) plus three-dimensional conformal planning radiotherapy sandwiched between gemcitabine chemotherapy is effective, tolerable, and safe in the management of pancreatic cancer. METHODS AND MATERIALS: Patients were enrolled in two strata: (1) resected pancreatic cancer at high risk of local relapse (postsurgery arm, n = 22) or (2) inoperable pancreatic cancer in head or body without metastases (locally advanced arm, n = 41). Gemcitabine was given at 1,000 mg/m(2) weekly for 3 weeks followed by 1 week rest then 5-6 weeks of radiotherapy and concurrent CI 5FU (200 mg/m(2)/day). After 4 weeks' rest, gemcitabine treatment was reinitiated for 12 weeks. RESULTS: For the two arms combined, treatment-related Grade 3 and 4 toxicities were reported by 25 (39.7%) and 7 (11.1%) patients, respectively. No significant late renal or hepatic toxicity was observed. In the postsurgery arm (R1 54.5%), median time to progressive disease from surgery was 11.0 months, median time to failure of local control was 32.9 months, and median survival time was 15.6 months. The 1- and 2-year survival rates were 63.6% and 31.8%. No significant associations between outcome and mutations in K-ras or TP53 or microsatellite instability were identified. Post hoc investigation of cancer antigen 19-9 levels found baseline levels and increases postbaseline were associated with shorter survival (p = 0.0061 and p < 0.0001, respectively). CONCLUSIONS: This three-dimensional chemoradiotherapy regimen is safe and promising, with encouraging local control for a substantial proportion of patients, and merits testing in a randomized trial.