caa a22 4500 445334819 CHVBK 20180317142751.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1245/s10434-010-1456-7 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1456-7 Preoperative Capecitabine and Concurrent Radiation for Borderline Resectable Pancreatic Cancer [Elektronische Daten] [Jayme Stokes, Norris Nolan, Edward Stelow, Dustin Walters, Geoffrey Weiss, Eduard de Lange, Tyvin Rich, Reid Adams, Todd Bauer] Background: Patients with borderline resectable pancreatic ductal adenocarcinoma (PDA) represent a high-risk group of patients due to tumor or patient-related characteristics. The optimal management of these patients has not been fully defined. Materials and Methods: All patients undergoing evaluation for PDA between 2005 and 2008 were identified. Clinical, radiographic, and pathological data were retrospectively reviewed. Patients were staged as borderline resectable using the M.D. Anderson Cancer Center (MDACC) classification. Results: A total of 170 patients with PDA were identified, 40 with borderline resectable disease. Of these, 34 borderline resectable patients (85%) completed neoadjuvant therapy and were restaged; pancreatic resection was completed in 16 patients (46%). Also, 8 patients completed 50Gy of radiation in 28 fractions in 6weeks, whereas 8 patients received 50Gy in 20 fractions in 4weeks plus chronomodulated capecitabine. An R0 resection was achieved in 12 of the 16 patients (75%). Also, 5 patients (63%) treated in 20 fractions had >90% pathologic response versus 1 (13%) treated in 28 fractions (P<.05). Borderline resectable patients completing surgery had similar survival to patients with resectable disease who underwent surgery. Patients receiving accelerated fractionation radiation had improved survival compared with patients treated with standard fractionation protocol. Conclusions: A neoadjuvant approach to borderline resectable PDA identifies patients who are most likely to benefit from pancreatic resection. Preoperative capecitabine-based chemoradiation is an effective, well-tolerated treatment for these patients. Neoadjuvant therapy for borderline resectable PDA warrants further investigation using treatment schedules that can safely intensify irradiation dose. Society of Surgical Oncology, 2011 Stokes Jayme Department of Surgery, University of Virginia Health System, Charlottesville, VA, USA aut Nolan Norris Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA aut Stelow Edward Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA aut Walters Dustin Department of Surgery, University of Virginia Health System, Charlottesville, VA, USA aut Weiss Geoffrey Department of Internal Medicine, University of Virginia Health System, Charlottesville, VA, USA aut de Lange Eduard Department of Radiology, University of Virginia Health System, Charlottesville, VA, USA aut Rich Tyvin Department of Radiation Oncology, University of Virginia Health System, Charlottesville, VA, USA aut Adams Reid Department of Surgery, University of Virginia Health System, Charlottesville, VA, USA aut Bauer Todd Department of Surgery, University of Virginia Health System, Charlottesville, VA, USA aut Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 619-627 1068-9265 18:3<619 2011 18 10434 https://doi.org/10.1245/s10434-010-1456-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1456-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Stokes Jayme Department of Surgery, University of Virginia Health System, Charlottesville, VA, USA aut NATIONALLICENCE 700 1- Nolan Norris Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA aut NATIONALLICENCE 700 1- Stelow Edward Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA aut NATIONALLICENCE 700 1- Walters Dustin Department of Surgery, University of Virginia Health System, Charlottesville, VA, USA aut NATIONALLICENCE 700 1- Weiss Geoffrey Department of Internal Medicine, University of Virginia Health System, Charlottesville, VA, USA aut NATIONALLICENCE 700 1- de Lange Eduard Department of Radiology, University of Virginia Health System, Charlottesville, VA, USA aut NATIONALLICENCE 700 1- Rich Tyvin Department of Radiation Oncology, University of Virginia Health System, Charlottesville, VA, USA aut NATIONALLICENCE 700 1- Adams Reid Department of Surgery, University of Virginia Health System, Charlottesville, VA, USA aut NATIONALLICENCE 700 1- Bauer Todd Department of Surgery, University of Virginia Health System, Charlottesville, VA, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 619-627 1068-9265 18:3<619 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer