Abstract
Aim:
Two sequential studies were performed to examine the effect of combination chemotherapy for patients with preoperative TNM stage III/IV advanced pancreatic cancer.
Methods:
In the first study, a randomized Phase II trial, comparing intraoperative radiation therapy (IORT) to IORT plus combination chemotherapy of methotrexate (MTX) and 5-fuluorouracil (5-FU) was performed. Based on the results of the first trial, a second randomized trial combination therapy comparing MTX plus 5-FU to that of cisplatin (CDDP) plus 5-FU was performed.
Results:
Thirty-three patients were entered into the first study. The second study was conducted sequentially and enrolled 27 patients. In the first study, overall survival and hospital-free survival were significantly better in the IORT plus MTX/5-FU group compared to the IORT alone group. In the second study, comparison of the overall survival and HFS between MTX/5FU group and CDDP/5FU group did not show any significant difference between the two groups. However, MTX/5-FU group showed better treatment compliance and less toxicity compared to the CDDP/5-FU group.
Conclusions:
The results of these two sequential studies of combination chemotherapies for advanced pancreatic cancer suggested that the treatment with IORT plus MTX/5FU was superior to the treatment without chemotherapy in the first study. In the second study, IORT plus MTX/5-FU was also shown to have less toxicity and better compliance compared to the IORT plus CDDP/5-FU.
