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KMID : 0859320060240040243
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Journal of the Korean Society for Therapeutic Radiology and Oncology
2006 Volume.24 No. 4 p.243 ~ p.247
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The Results of Palliative Radiation Therapy in Patients with Unresectable
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Ryu Mi-Ryeong
Yoon Sei-Chul
Kim Yeon-Sil
Chung Su-Mi
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Abstract
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Purpose: To evaluate the treatment results and prognostic factors of palliative radiation therapy in the patients
with unresectable advanced pancreatic cancer.
Materials & Methods: Thirty-seven evaluable patients with unresectable advanced pancreatic cancer who
were treated by palliative radiation therapy for pain relief at the Department of Radiation Oncology, Kangnam
St. Mary’s hospital, the Catholic University of Korea between March 1984 and February 2005 were analysed
retrospectively. There were 22 men and 15 women. Age at diagnosis ranged from 30 to 80 (median 57) years.
Twelve patients (32.4%) had liver metastases and 22 patients (59.5%) had lymph node metastases. Radiation
therapy was delivered to primary tumor and regional lymph nodes with 1∼2 cm margin, and total dose was
3,240∼5,580 cGy (median 5,040 cGy). Chemotherapy with radiotherapy was delivered in 30 patients (81%) with
5-FU alone (21 patients) or gemcitabine (9 patients). The follow-up period ranged from 1 to 44 months.
Survival and prognostic factors were analysed using Kaplan-Meier method and log-rank test respectively.
Results: Overall mean and median survival were 11 and 8 months and 1-year survival rate was 20%. Among
33 patients who were amenable for response evaluation, 7 patients had good response and 22 patients had
fair response with overall response rate of 87.9%. Mild to moderate toxicity were observed in 14 patients with
nausea, vomiting, and indigestion, but severe toxicity requiring interruption of treatment were not observed.
Chemotherapy didn’t influence the survival and symptomatic palliation, but the group containing gemcitabine
showed a tendency of longer survival (median 12 months) than 5-FU alone group (median 5.5 months) without
statistical significance (p＞0.05). The significant prognostic factors were Karnofsky performance status and liver
metastasis (p＜0.05). Age, sex, tumor location, lymph node metastasis, and CA 19-9 level did not show any
prognostic significance (p＞0.05).
Conclusion: Radiation therapy was effective for symptomatic palliation in the patients with unresectable
advanced pancreatic cancer and would play an important part in the survival benefit with gemcitabine or other
targeted agents.
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KEYWORD
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Unresectable pancreatic cancer, Radiation therapy, Symptomatic palliation
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