• Hiroyuki Kawakami, Takashi Uno, Kouichi Isobe, Naoyuki Ueno, Takashi Aruga, Kentaro Sudo, Taketo Yamaguchi, Hiromitsu Saisho, Tetsuya Kawata, and Hisao Ito.
• Department of Radiology, Chiba University Graduate School of Medicine, Chuou-ku, Chiba-City, Chiba, Japan.
• Int. J. Radiat. Oncol. Biol. Phys. 2005 Aug 1; 62 (5): 1357-62.

PurposeTo evaluate local effects and acute toxicities of involved field irradiation with concurrent cisplatin (CDDP) for unresectable pancreatic carcinoma.Materials And MethodsThirty-three patients with unresectable pancreatic carcinoma were treated with chemoradiotherapy. Sixteen were Stage IVA; 17 were Stage IVB. The total prescribed dose of radiotherapy was 50 Gy/25 fractions or 50.4 Gy/28 fractions, using a three-dimensionally determined involved-field that included only the primary tumor and clinically enlarged lymph nodes. Twelve patients received a daily i.v. infusion of CDDP; 21 patients received a combination of CDDP and 5-fluorouracil either i.v. or through the proper hepatic artery.ResultsTwenty-seven (82%) patients completed planned chemoradiotherapy. Nausea was the most frequent complaint. No patient experienced Grade 4 toxicities. More than half achieved pain relief. As for the primary site, only 4 patients (12%) achieved a partial response at 4 weeks; however, 3 additional patients attained >50% tumor reduction thereafter. The most frequent site of disease progression was the liver, and only 3 patients developed local progression alone. No regional lymph nodal progression outside the treatment field was seen. Median survival time and survival at 1 year were 7.1 months and 27%, respectively, for the entire group. Difference in overall survival between patients with and without distant metastases was significant (p = 0.01).ConclusionsInvolved-field irradiation with concurrent daily CDDP was well tolerated without compromising locoregional effects.

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