Neoadjuvant strategies for pancreatic cancer

Table 4 Studies on neoadjuvant chemoradiotherapy for locally advanced pancreatic cancer

Ref.	Study type	CT regimen	RT	Staging System	LAPC (n)	Resection rate (%)	R0 resections/total resections	ORR (%)	OS median (mo)
Shinchi et al[57]	Prospective randomized trial	5-FU concurrent infusion	External beam RT (50.4 Gy/28 fractions) vs no RT	NR	31	NR	NR	31	13.2 vs 6.4
Tinkl et al[60]	Prospective study	Gemcitabine	Three dimensional conformal55.8 Gy tumor50.4 Gy nodes	NR	120	31.6	35/38	NR	25
Kim et al[61]	Phase I study	Gemcitabine + oxaliplatin	Concurrent external beam RT27 Gy/15 fractions	NCCN	38	28.9	7/11	15.7	12.5 (all patients)
Huguet et al[62]	Phase II and III trial	Upfront CT: FOLFUGEM, GEMOX, Gemcitabine vs GEMOX167 patients	External beam RT(55 Gy/30 fractions)72 patients	NR	167	NR	NR	NR	13.1
Krishnan et al[63]	Prospective non-randomized trial	Chemoradiation (247 patients)Upfront GEM CT followed by CRT5-FU, GEM, CAPE(76 patients)	30 Gy (220 patients) or55 Gy (27 patients) 30 Gy (64 patients) or55 Gy (12 patients)	MDACC	323	NR	NR	NR	9.1
Mukerjee et al[64]	Open label, randomized, phase II trial	Upfront CT GEM or CAPE CRT GEM or CAPE	58 Gy/30 fractions	NR	7438 GEM36 CAPE	NR	NR	20.2	15.2 (GEM) vs 13.4 (CAPE)
Leone et al[65]	Prospective non-randomized trial	Upfront CT GEMOX CRT GEM	50.4 Gy	NCCN	3915 BR24 UR	28.2	11/11	NR	16.7 27.8 BR 13.3 UR
Polistina et al[76]	Prospective non-randomized trial	Upfront GEM CTGEM CRT	SBRT30 Gy/3 fractions	MDACC	23 UR	8	2/3	69.5	10.6

NR: Not reported; RT: Radiotherapy; CT: Chemotherapy; CRT: Chemoradiotherapy; LAPC: Locally advanced pancreatic cancer; ORR: Overall response rate; OS: Overall Survival; GEM: Gemcitabine; CAPE: Capecitabine; FOLFUGEM: Leucovorin + gemcitabine + 5-fluorouracil; GEMOX: Gemcitabine + Oxaliplatin; NCCN: National comprehensive cancer network; MDACC: MD Anderson Cancer Center; BR: Borderline resectable; UR: Unresectable; SBRT: Stereotactic body radiotherapy.