Evolving trends in combined modality therapy for pancreatic cancer

1998 ◽  
Vol 5 (3) ◽  
pp. 227-234 ◽  
Author(s):  
William F. Regine ◽  
William J. John ◽  
Mohammed Mohiuddin
Keyword(s):  
Pancreatic Cancer ◽  
Combined Modality Therapy ◽  
Combined Modality

Combined Modality Therapy Increasing Local Control of Pancreatic Cancer

1993 ◽  
Vol 11 (3) ◽  
pp. 241-246 ◽  
Author(s):  
Howard W. Bruckner ◽  
Shalom Kalnicki ◽  
Jack Dalton ◽  
Gary K. Schwartz ◽  
Margaret R. Chesser ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Local Control ◽  
Combined Modality Therapy ◽  
Combined Modality

Preoperative combined modality therapy for pancreatic cancer

1995 ◽  
Vol 19 (2) ◽  
pp. 264-269 ◽  
Author(s):  
Tvvin A. Rich ◽  
Douglas B. Evans
Keyword(s):  
Pancreatic Cancer ◽  
Combined Modality Therapy ◽  
Combined Modality

Survival After Combined Modality Therapy for Pancreatic Cancer

1993 ◽  
Vol 16 (3) ◽  
pp. 199-203 ◽  
Author(s):  
Howard W. Bruckner ◽  
Shalom Kalnicki ◽  
Jack Dalton ◽  
Harry Snady ◽  
Gary K. Schwartz ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Combined Modality Therapy ◽  
Combined Modality

Role of chemoradiation in locally advanced pancreatic cancer: A systematic review and meta-analysis.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 348-348
Author(s):  
Adnan Nagrial ◽  
Venessa T. Chin ◽  
Chelsie O'Connor ◽  
Katrin Marie Sjoquist ◽  
Lorraine A. Chantrill ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Cancer ◽  
Adverse Events ◽  
Confidence Intervals ◽  
Combined Modality Therapy ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Combined Modality

348 Background: The role of combined modality therapy in the management of locally advanced pancreatic cancer (LAPC) is uncertain. Current guidelines recommend combined modality therapy for select patients. We sought to review the evidence for combined modality versus single modality therapy in LAPC. We performed a systematic review and meta-analysis of randomised controlled trials (RCT) comparing chemoradiation versus chemotherapy alone as well as chemoradiation versus radiation alone in patients with LAPC. Methods: We searched MEDLINE, EMBASE and CENTRAL from inception to Oct 2013 for RCTs comparing chemotherapy alone versus chemotherapy plus radiation and radiation alone versus chemotherapy plus radiation. We also searched abstracts of major cancer meetings from 1990 to 2013. The primary outcome was overall survival (OS). Secondary outcomes included progression-free survival (PFS), response rate and adverse events. Hazard ratios (HR), confidence intervals (CI) and p-values (p) were estimated with a random-effects model due to the heterogeneity of included studies using Revman 5.3. Results: We included 7 eligible trials including 753 patients. Induction chemotherapy was delivered prior to randomisation in one study. Chemoradiation versus chemotherapy (n= 5 studies) did not improve PFS (HR 1.02, 95% CI 0.87 - 1.20, p = 0.80) or OS (HR 0.91, 95% CI 0.64 - 1.31, p = 0.61). However, chemoradiation versus radiation (n=2 studies) improved PFS (HR 0.63, 95% CI 0.41 - 0.96, p = 0.03) and OS (HR 0.65, 95% CI 0.43 – 0.96, p = 0.03). There was significant statistical heterogeneity in the included studies and subsequently wide confidence intervals in the pooled results. This is most likely due to the small participant numbers in each study. Adverse events were more frequent in the chemoradiation arms. Response rates were assessed in only two studies. Conclusions: Chemoradiation is not superior to chemotherapy alone in LAPC, but may be superior to radiation alone. The studies were small with significant heterogeneity. Combined modality therapy results in increased adverse events. Our results do not provide evidence for a universal standard of care, thus more studies of combined modality therapy in LAPC are needed.

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