- 作者：Theodore S. Hong ; David P. Ryan ; Lawrence S. Blaszkowsky ; Harvey J. Mamon ; Eunice L. Kwak ; Mari Mino-Kenudson ; Judith Adams ; Beow Yeap ; Barbara Winrich ; Thomas F. DeLaney ; Carlos Fern ; ez-Del Castillo
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2011
- 出版时间：1 January 2011
- 年：2011
- 卷：79
- 期：1
- 页码：151-157
- 全文大小：692 K
Purpose
To evaluate the safety of 1 week of chemoradiation with proton beam therapy and capecitabine followed by early surgery.Methods and Materials
Fifteen patients with localized resectable, pancreatic adenocarcinoma of the head were enrolled from May 2006 to September 2008. Patients received radiation with proton beam. In dose level 1, patients received 3 GyE × 10 (Week 1, Monday–Friday; Week 2, Monday–Friday). Patients in Dose Levels 2 to 4 received 5 GyE × 5 in progressively shortened schedules: level 2 (Week 1, Monday, Wednesday, and Friday; Week 2, Tuesday and Thursday), Level 3 (Week 1, Monday, Tuesday, Thursday, and Friday; Week 2, Monday), Level 4 (Week 1, Monday through Friday). Capecitabine was given as 825 mg/m2 b.i.d. Weeks 1 and 2 Monday through Friday for a total of 10 days in all dose levels. Surgery was performed 4 to 6 weeks after completion of chemotherapy for Dose Levels 1 to 3 and then after 1 to 3 weeks for Dose Level 4.
Results
Three patients were treated at Dose Levels 1 to 3 and 6 patients at Dose Level 4, which was selected as the MTD. No dose limiting toxicities were observed. Grade 3 toxicity was noted in 4 patients (pain in 1; stent obstruction or infection in 3). Eleven patients underwent resection. Reasons for no resection were metastatic disease (3 patients) and unresectable tumor (1 patient). Mean postsurgical length of stay was 6 days (range, 5–10 days). No unexpected 30-day postoperative complications, including leak or obstruction, were found.
Conclusions
Preoperative chemoradiation with 1 week of proton beam therapy and capecitabine followed by early surgery is feasible. A Phase II study is underway.