ArticleFukushima journal of medical science2026
Evaluating preoperative gemcitabine-based chemoradiation for resectable and borderline resectable pancreatic cancer: a phase 1 study.
Article in Fukushima journal of medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeNeoadjuvant pancreatic ductal adenocarcinoma (PDAC) treatment is evolving, and chemoradiotherapy (CRT) is emerging as a promising strategy for neoadjuvant therapy. Given the variability in radiotherapy protocols, this study aimed to evaluate the feasibility and safety of gemcitabine-based neoadjuvant chemoradiotherapy.
methodsIn this single-arm, phase 1 clinical trial, 31 patients with PDAC were enrolled between April 2016 and August 2019. All patients received preoperative gemcitabine-based chemoradiotherapy with adverse events as the primary endpoint. Multichannel radiation was administered at a total dose of 54 Gy in daily fractions of 1.8 Gy (five fractions per week), which represents a novel aspect of this study.
resultsNeoadjuvant therapy was completed in 24 patients, while seven were discontinued due to disease progression. The common adverse events included leukopenia (48.3%), thrombocytopenia (12.9%), and anemia (3.2%). Among the patients who underwent pancreatectomy, the R0 resection rate was 95.8%. Intention-to-treat analysis indicated a 2-year overall survival rate of 49.8% and a 2-year recurrence-free survival rate of 42.4%. High pretreatment CA19-9 levels were identified as predictive factors for overall survival (HR = 28.7, 95% CI:5.00-164.3).
conclusionsGemcitabine-based neoadjuvant chemoradiotherapy is a feasible and effective approach for achieving high R0 resection rates in resectable and borderline PDAC.
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