{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T13:41:57Z","timestamp":1773409317615,"version":"3.50.1"},"reference-count":20,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2000,2,14]]},"abstract":"<jats:p> PURPOSE: A recent multicenter study of preoperative chemoradiation and pancreaticoduodenectomy for localized pancreatic adenocarcinoma suggested that biliary stent\u2013related complications are frequent and severe and may prevent the delivery of all components of multimodality therapy in many patients. The present study was designed to evaluate the rates of hepatic toxicity and biliary stent\u2013related complications and to evaluate the impact of this morbidity on the delivery of preoperative chemoradiation for pancreatic cancer at a tertiary care cancer center. <\/jats:p><jats:p> PATIENTS AND METHODS: Preoperative chemoradiation was used in 154 patients with resectable pancreatic adenocarcinoma (142 patients, 92%) or other periampullary tumors (12 patients, 8%). Patients were treated with preoperative fluorouracil (115 patients), paclitaxel (37 patients), or gemcitabine (two patients) plus concurrent rapid-fractionation (30 Gy; 123 patients) or standard-fractionation (50.4 Gy; 31 patients) radiation therapy. The incidences of hepatic toxicity and biliary stent\u2013related complications were evaluated during chemoradiation and the immediate 3- to 4-week postchemoradiation preoperative period. <\/jats:p><jats:p> RESULTS: Nonoperative biliary decompression was performed in 101 (66%) of 154 patients (endobiliary stent placement in 77 patients and percutaneous transhepatic catheter placement in 24 patients). Stent-related complications (occlusion or migration) occurred in 15 patients. Inpatient hospitalization for antibiotics and stent exchange was necessary in seven of 15 patients (median hospital stay, 3 days). No patient experienced uncontrolled biliary sepsis, hepatic abscess, or stent-related death. <\/jats:p><jats:p> CONCLUSION: Preoperative chemoradiation for pancreatic cancer is associated with low rates of hepatic toxicity and biliary stent\u2013related complications. The need for biliary decompression is not a clinically significant concern in the delivery of preoperative therapy to patients with localized pancreatic cancer. <\/jats:p>","DOI":"10.1200\/jco.2000.18.4.860","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T07:02:08Z","timestamp":1487919728000},"page":"860-860","source":"Crossref","is-referenced-by-count":65,"title":["Preoperative Chemoradiation for Patients With Pancreatic Cancer: Toxicity of Endobiliary Stents"],"prefix":"10.1200","volume":"18","author":[{"given":"Peter W. T.","family":"Pisters","sequence":"first","affiliation":[{"name":"From the Pancreatic Tumor Study GroupThe University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne A.","family":"Hudec","sequence":"additional","affiliation":[{"name":"From the Pancreatic Tumor Study GroupThe University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey E.","family":"Lee","sequence":"additional","affiliation":[{"name":"From the Pancreatic Tumor Study GroupThe University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaac","family":"Raijman","sequence":"additional","affiliation":[{"name":"From the Pancreatic Tumor Study GroupThe University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep","family":"Lahoti","sequence":"additional","affiliation":[{"name":"From the Pancreatic Tumor Study GroupThe University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nora A.","family":"Janjan","sequence":"additional","affiliation":[{"name":"From the Pancreatic Tumor Study GroupThe University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyvin A.","family":"Rich","sequence":"additional","affiliation":[{"name":"From the Pancreatic Tumor Study GroupThe University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher H.","family":"Crane","sequence":"additional","affiliation":[{"name":"From the Pancreatic Tumor Study GroupThe University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato","family":"Lenzi","sequence":"additional","affiliation":[{"name":"From the Pancreatic Tumor Study GroupThe University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A.","family":"Wolff","sequence":"additional","affiliation":[{"name":"From the Pancreatic Tumor Study GroupThe University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James L.","family":"Abbruzzese","sequence":"additional","affiliation":[{"name":"From the Pancreatic Tumor Study GroupThe University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas B.","family":"Evans","sequence":"additional","affiliation":[{"name":"From the Pancreatic Tumor Study GroupThe University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"R1-0095","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199806000-00005"},{"key":"R2-0095","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199603000-00007"},{"key":"R3-0095","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19870615)59:12<2006::AID-CNCR2820591206>3.0.CO;2-B"},{"key":"R4-0095","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.3.928"},{"key":"R5-0095","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199705000-00018"},{"key":"R6-0095","doi-asserted-by":"publisher","DOI":"10.1067\/msy.1998.91487"},{"key":"R7-0095","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199912000-00006"},{"key":"R8-0095","unstructured":"Pendurthi  TK,  Hoffman  JP,  Ross  E, et al:  Preoperative versus postoperative chemoradiation for patients with resected pancreatic adenocarcinoma.  Am Surg 64:686,1998-692,"},{"key":"R9-0095","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.12.3843"},{"key":"R10-0095","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.1.317"},{"key":"R11-0095","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1992.01420110083017"},{"key":"R12-0095","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(99)80085-3"},{"key":"R13-0095","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(94)90060-4"},{"key":"R14-0095","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1958.10501452"},{"key":"R15-0095","doi-asserted-by":"publisher","DOI":"10.1007\/BF02065519"},{"key":"R16-0095","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(88)71407-8"},{"key":"R17-0095","unstructured":"Siegel  JH,  Pullano  WE,  Wright  G:  The ultimate large caliber endoprosthesis-12F:  Poiseuille was right\u2014Bigger is better. Gastrointest Endosc 31:158,1985-159,   (abstr 137)"},{"key":"R18-0095","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(98)70291-3"},{"key":"R19-0095","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)92752-2"},{"key":"R20-0095","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1010294"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.2000.18.4.860","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T21:38:46Z","timestamp":1653514726000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.2000.18.4.860"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,2,14]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2000,2,14]]}},"alternative-id":["10.1200\/JCO.2000.18.4.860"],"URL":"https:\/\/doi.org\/10.1200\/jco.2000.18.4.860","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,2,14]]}}}