Mayo Clinic study reports improved survival rates for pancreas cancer patients treated with new approach

Friday, May 30, 2008

SCOTTSDALE, Ariz. –A study of patients with locally unresectable or borderline resectable pancreas cancer has indicated that the disease survival rates can potentially be doubled by aggressively combining radiation, chemotherapy and surgery.

Study participants received a robust treatment of full-dose, pre-operative chemo-radiation (CRT) prior to surgery, plus intraoperative electron irradiation (IOERT) during surgery. Their long-term survival rate and disease control improved over extended periods of time. The study reported that median survival rates among patients treated in the past six years with the new protocol more than doubled from ~9 months with traditional treatment to 19 months.

In 12 patients who had surgical removal of the pancreas cancer plus IOERT after preop chemo-radiation, median survival was 23 months vs 10 months in the 14 without surgical removal, and the three-year survival rate was 43 vs 0%. Four of 26 patients treated with the new approach currently show no sign of the disease.

The study was headed by Leonard L. Gunderson, M.D., Getz Family Professor at Mayo's Department of Radiation Oncology and Deputy Director for Clinical Affairs at Mayo Clinic Cancer Center – Arizona. Dr. Gunderson joined Mayo Clinic Arizona in 2001 and was a pioneer in the development of IOERT at Mayo Clinic in Rochester, Minn., and at Massachusetts General Hospital and Harvard Medical School.

"In the past, patients with unresectable tumors would have been treated with radiation and chemo, or chemo alone," says Dr. Gunderson. "That provided some extension of life, but not long-term survival.

"In this study, we were trying to push the envelope by putting everything together to increase the long-term cure rate," he said. "It was pleasing that the margin of improvement we achieved was as significant as it was."

Each year more than 33,000 persons in the United States are diagnosed with pancreatic cancer, one of the more deadly types of malignant tumors.

Depending on the extent of the tumor, the prognosis is generally poor—few patients survive five years after diagnosis and complete remission is extremely rare.

Dr. Gunderson will deliver an oral presentation on the project's results to radiation oncologists and surgeons attending the International

Society of Intraoperative Radiation Therapy convention (ISIORT) in Madrid, Spain in June. The results will also be written for later publication.

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Mayo Clinic Cancer Center is one of only 39 U.S. medical centers that have been named as a National Cancer Institute (NCI) Comprehensive Cancer Center. To receive this designation, an institution must meet rigorous standards demonstrating scientific excellence and the ability to integrate diverse research approaches to address the problem of cancer. Mayo Clinic Cancer Center is the only national, multi-site center with the NCI's Comprehensive Cancer Center designation. In Arizona, Mayo's clinical and research experts work together to address the complex needs of cancer patients, with a dedication to understanding the biology of cancer; discovering new ways to predict, prevent, diagnose and treat cancer; and transforming the quality of life for cancer patients today and in the future.

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