{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:53:02Z","timestamp":1792151582337,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2004,9,29]],"date-time":"2004-09-29T00:00:00Z","timestamp":1096416000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2004,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Gemcitabine sensitizes tumor cells to radiation and cisplatin and thereby enhances the cytotoxic effect of gemcitabine. Here we report the efficacy and toxicity of concurrent chemoradiation with gemcitabine and cisplatin in the treatment of patients with locally advanced, unresectable pancreatic cancer. A total of 47 patients (29\u00a0men, 18 women; median age 61 years) with histologically proven advanced pancreatic carcinoma were included in the study. They underwent chemotherapy with gemcitabine 300\u00a0mg\/m<jats:sup>2<\/jats:sup> and cisplatin 30\u00a0mg\/m<jats:sup>2<\/jats:sup> on days 1, 8, 22, and 29; concurrent radiation (45\u201450\u00a0Gy) was applied to the tumor and regional lymph nodes (1.8\u20142.0\u00a0Gy\/fraction 5\u00a0days per week). Subsequent to chemoradiotherapy, treatment was continued with more two cycles of gemcitabine (1000\u00a0mg\/m<jats:sup>2<\/jats:sup>) and cisplatin (50\u00a0mg\/m<jats:sup>2<\/jats:sup>) applied on days 1 and 15 of a 4\u2010week cycle. After completion of chemoradiotherapy, 9 patients (19.1%) achieved a complete response and 23 patients (48.9%) a partial response, for an overall response rate of 68%. The lesions were considered resectable in 27 patients, and 25 of the 27 patients underwent laparotomy. The other 20 patients underwent a definitive pancreatic resection. Altogether, 13 patients had negative surgical margins. With a median follow\u2010up of 25.7\u00a0months (range 12.7\u201438.7\u00a0months) after completion of chemoradiation, distant metastasis had occurred in 23 patients and local recurrence in only 4 of 44 patients (8.5%). the median progression\u2010free survival was 7.8\u00a0months (range 6.2\u20149.4\u00a0months). The median survival amounted to 10.7\u00a0months (range 8.4\u201413.0\u00a0months) for all patients, whereas it was prolonged to 24.2\u00a0months (range 6.8\u201441.7\u00a0months) for those undergoing R0 resection. The main toxicities associated with chemoradiation included grade 3\/4 leukopenia (68% of patients) and thrombocytopenia (61%). Episodes of cholangitis were observed in 11 patients. We concluded that gemcitabine and cisplatin can safely be combined with external beam radiation. This preoperative treatment approach is highly effective and appears to improve survival in patients whose tumors are rendered completely resectable.<\/jats:p>","DOI":"10.1007\/s00268-004-7338-z","type":"journal-article","created":{"date-parts":[[2004,10,2]],"date-time":"2004-10-02T03:41:56Z","timestamp":1096688516000},"page":"1011-1018","source":"Crossref","is-referenced-by-count":46,"title":["Effect of Chemoradiotherapy with Gemcitabine and Cisplatin on Locoregional Control in Patients with Primary Inoperable Pancreatic Cancer"],"prefix":"10.1002","volume":"28","author":[{"given":"Ralf","family":"Wilkowski","sequence":"first","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Strahlentherapie und Radioonkologie Klinikum Grosshadern der LMU M\u00fcnchen Marchioninistrasse 15 81377 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Thoma","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Strahlentherapie und Radioonkologie Klinikum Grosshadern der LMU M\u00fcnchen Marchioninistrasse 15 81377 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Schauer","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik und Poliklinik Klinikum Grosshadern der LMU M\u00fcnchen Marchioninistrasse 15 81377 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Wagner","sequence":"additional","affiliation":[{"name":"Medizinische Klinik II Klinikum Grosshadern der LMU M\u00fcnchen Marchioninistrasse 15 81377 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Heinemann","sequence":"additional","affiliation":[{"name":"Medizinische Klinik III Klinikum Grosshadern der LMU M\u00fcnchen Marchioninistrasse 15 81377 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,9,29]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.annonc.a059031"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.46.1.5"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19811015)48:8<1705::AID-CNCR2820480803>3.0.CO;2-4"},{"key":"e_1_2_8_5_2","first-page":"213","article-title":"Treatment of locally unresectable carcinoma of the pancreas: comparison of combined\u2010modality therapy (chemotherapy plus radiotherapy) to chemotherapy alone","volume":"23","author":"Gastrointestinal Tumor Study Group","year":"1988","journal-title":"J. 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