Journal ArticleDOI
A Randomized Trial of Chemoradiotherapy and Chemotherapy after Resection of Pancreatic Cancer
John P. Neoptolemos,Deborah D. Stocken,Helmut Friess,Claudio Bassi,Janet A. Dunn,Helen Hickey,Hans G. Beger,Laureano Fernández-Cruz,Christos Dervenis,François Lacaine,Massimo Falconi,Paolo Pederzoli,Akos F. Pap,David Spooner,David J. Kerr,Markus W. Büchler +15 more
TLDR
Adjuvant chemotherapy has a significant survival benefit in patients with resected pancreatic cancer, whereas adjuvant chemoradiotherapy has a deleterious effect on survival.Abstract:
background The effect of adjuvant treatment on survival in pancreatic cancer is unclear. We report the final results of the European Study Group for Pancreatic Cancer 1 Trial and update the interim results. methods In a multicenter trial using a two-by-two factorial design, we randomly assigned 73 patients with resected pancreatic ductal adenocarcinoma to treatment with chemoradiotherapy alone (20 Gy over a two-week period plus fluorouracil), 75 patients to chemotherapy alone (fluorouracil), 72 patients to both chemoradiotherapy and chemotherapy, and 69 patients to observation. results The analysis was based on 237 deaths among the 289 patients (82 percent) and a median follow-up of 47 months (interquartile range, 33 to 62). The estimated five-year survival rate was 10 percent among patients assigned to receive chemoradiotherapy and 20 percent among patients who did not receive chemoradiotherapy (P=0.05). The five-year survival rate was 21 percent among patients who received chemotherapy and 8 percent among patients who did not receive chemotherapy (P=0.009). The benefit of chemotherapy persisted after adjustment for major prognostic factors. conclusions Adjuvant chemotherapy has a significant survival benefit in patients with resected pancreatic cancer, whereas adjuvant chemoradiotherapy has a deleterious effect on survival.read more
Citations
More filters
Journal ArticleDOI
Erlotinib Plus Gemcitabine Compared With Gemcitabine Alone in Patients With Advanced Pancreatic Cancer: A Phase III Trial of the National Cancer Institute of Canada Clinical Trials Group
Malcolm J. Moore,David Goldstein,John T. Hamm,Arie Figer,J. R. Hecht,Steven Gallinger,Heather J. Au,Pawel Murawa,David Walde,Robert A. Wolff,D. M. B. Campos,Robert Lim,Keyue Ding,Gary M. Clark,Theodora Voskoglou-Nomikos,Mieke Ptasynski,Wendy R. Parulekar +16 more
TL;DR: To the authors' knowledge, this randomized phase III trial is the first to demonstrate statistically significantly improved survival in advanced pancreatic cancer by adding any agent to gemcitabine.
Journal ArticleDOI
Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial.
Helmut Oettle,Stefan Post,Peter Neuhaus,Klaus Gellert,Jan M. Langrehr,Karsten Ridwelski,Harald Schramm,J. Fahlke,Carl Zuelke,Christof Burkart,Klaus Gutberlet,E. Kettner,Harald Schmalenberg,Karin Weigang-Koehler,Wolf O. Bechstein,Marco Niedergethmann,Ingo G.H. Schmidt-Wolf,Lars Roll,Bernd Doerken,Hanno Riess +19 more
TL;DR: The results support the use of gemcitabine as adjuvant chemotherapy in resectable carcinoma of the pancreas by significantly delayed the development of recurrent disease after complete resection of pancreatic cancer compared with observation alone.
Journal ArticleDOI
EMT and Dissemination Precede Pancreatic Tumor Formation
Andrew D. Rhim,Emily T. Mirek,Nicole M. Aiello,Anirban Maitra,Jennifer M. Bailey,Florencia McAllister,Maximilian Reichert,Gregory L. Beatty,Anil K. Rustgi,Robert H. Vonderheide,Steven D. Leach,Ben Z. Stanger +11 more
TL;DR: It is suggested that inflammation enhances cancer progression in part by facilitating EMT and entry into the circulation and tagged cells invaded and entered the bloodstream unexpectedly early, before frank malignancy could be detected by rigorous histologic analysis.
Journal ArticleDOI
FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer
Thierry Conroy,Pascal Hammel,Mohamed Hebbar,Meher Ben Abdelghani,Alice C. Wei,Jean-Luc Raoul,Laurence Chone,Eric Francois,Pascal Artru,James Joseph Biagi,Thierry Lecomte,Eric Assenat,Roger Faroux,Marc Ychou,Julien Volet,Alain Sauvanet,Gilles Breysacher,Frédéric Di Fiore,Christine Cripps,Petr Kavan,Patrick Texereau,Karine Bouhier-Leporrier,Faiza Khemissa-Akouz,Jean-Louis Legoux,Beata Juzyna,Sophie Gourgou,Christopher J. O'Callaghan,Claire Jouffroy-Zeller,Patrick Rat,David Malka,Florence Castan,Jean-Baptiste Bachet +31 more
TL;DR: Adjuvant therapy with a modified FOLFIRINOX regimen led to significantly longer survival than gemcitabine among patients with resected pancreatic cancer, at the expense of a higher incidence of toxic effects.
Journal ArticleDOI
Clinical practice guidelines in oncology
William J. Gradishar,Benjamin O. Anderson,Ron Balassanian,Sarah L. Blair,Harold J. Burstein,Amy E. Cyr,Anthony D. Elias,William B. Farrar,Andres Forero,Sharon H. Giordano,Matthew P. Goetz,Lori J. Goldstein,Steven J. Isakoff,Janice A. Lyons,P. Kelly Marcom,Ingrid A. Mayer,Beryl McCormick,Meena S. Moran,Ruth O'Regan,Sameer A. Patel,Lori J. Pierce,Elizabeth C. Reed,Kilian E. Salerno,Lee S. Schwartzberg,Amy Sitapati,Karen L. Smith,Mary Lou Smith,Hatem Soliman,George Somlo,Melinda L. Telli,John H. Ward,Rashmi Kumar,Dorothy A. Shead +32 more
TL;DR: This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.
References
More filters
Book ChapterDOI
Nonparametric Estimation from Incomplete Observations
Edward L. Kaplan,Paul Meier +1 more
TL;DR: In this article, the product-limit (PL) estimator was proposed to estimate the proportion of items in the population whose lifetimes would exceed t (in the absence of such losses), without making any assumption about the form of the function P(t).
Book ChapterDOI
Regression Models and Life-Tables
TL;DR: The analysis of censored failure times is considered in this paper, where the hazard function is taken to be a function of the explanatory variables and unknown regression coefficients multiplied by an arbitrary and unknown function of time.
Journal ArticleDOI
The European Organization for Research and Treatment of Cancer QLQ-C30: A Quality-of-Life Instrument for Use in International Clinical Trials in Oncology
Neil K. Aaronson,Sam H Ahmedzai,Bengt Bergman,Monika Bullinger,Ann Cull,Nicole Duez,Antonio Filiberti,Henning Flechtner,Stewart B. Fleishman,Johanna C. J. M. de Haes,Stein Kaasa,M. Klee,David Osoba,Darius Razavi,Peter B. Rofe,Simon Schraub,Kommer C. A. Sneeuw,Marianne Sullivan,Fumikazu Takeda +18 more
TL;DR: The reliability and validity of the EORTC QLQ-C30 questionnaire were highly consistent across the three language-cultural groups studied: patients from English-speaking countries, Northern Europe, and Southern Europe.
Journal ArticleDOI
Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples.
Richard Peto,M.C. Pike,P. Armitage,N. E. Breslow,David Cox,S V Howard,N Mantel,Klim McPherson,Julian Peto,Pete Smith +9 more
TL;DR: Efficient methods of analysis of randomized clinical trials in which the authors wish to compare the duration of survival among different groups of patients are described.
Journal ArticleDOI
Cancer statistics, 2003.
TL;DR: The American Cancer Society estimates the number of new cancer cases and deaths expected in the United States in the current year, and compiles the most recent data on cancer incidence, mortality, and survival by using incidence data from the National Cancer Institute (NCI) and mortality data from National Center for Health Statistics (NCHS).
Related Papers (5)
Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial.
Helmut Oettle,Stefan Post,Peter Neuhaus,Klaus Gellert,Jan M. Langrehr,Karsten Ridwelski,Harald Schramm,J. Fahlke,Carl Zuelke,Christof Burkart,Klaus Gutberlet,E. Kettner,Harald Schmalenberg,Karin Weigang-Koehler,Wolf O. Bechstein,Marco Niedergethmann,Ingo G.H. Schmidt-Wolf,Lars Roll,Bernd Doerken,Hanno Riess +19 more
Pancreatic cancer. Adjuvant combined radiation and chemotherapy following curative resection.
M H Kalser,Susan S. Ellenberg +1 more
FOLFIRINOX versus Gemcitabine for Metastatic Pancreatic Cancer
Thierry Conroy,Françoise Desseigne,Marc Ychou,Olivier Bouché,Rosine Guimbaud,Yves Becouarn,Antoine Adenis,Jean-Luc Raoul,Sophie Gourgou-Bourgade,Jaafar Bennouna,Jean-Baptiste Bachet,Faiza Khemissa-Akouz,Denis Péré-Vergé,Catherine Delbaldo,Eric Assenat,Bruno Chauffert,C. Montoto-Grillot,Michel Ducreux +17 more