Small-field radiotherapy in combination with concomitant chemotherapy for locally advanced pancreatic carcinoma

Purpose: To evaluate the effectiveness of small-field radiotherapy in combination with concomitant 5-fluorouracil (5FU) or cisplatin for locally advanced pancreatic carcinoma. Materials and methods: From November 1993 to January 1999, 53 patients underwent continuous 5FU infusion at 200 mg/m² (27 patients) or a 30-min cisplatin infusion at 5 mg/m²/day (26 patients) just prior to each irradiation. The radiation field was limited to cover the primary and the paraaortic regions at celiac and supramesenteric axis levels. A total dose of 50.4 Gy in 28 sessions was given in 5.6 weeks. Results: Median and 1-year survival rates were 10.2 months and 35.2%, respectively. Local failure occurred in 19 patients (36%) and liver metastases in 16 patients (30%). All local recurrences occurred only within the radiation field. Conclusions: Median survival rates were comparable to other studies. Because local failure occurred only within the radiation field, the use of relatively small-field radiotherapy may be justified in the treatment of locally advanced pancreatic carcinoma in addition to concurrent administration of either 5FU or cisplatin.