Randomized phase II study of chemoradiotherapy with versus without induction chemotherapy for locally advanced pancreatic cancer: Japan Clinical Oncology Group trial, JCOG1106

Abstract Background Chemoradiotherapy is a treatment option for locally advanced pancreatic cancer. However, the efficacy of induction chemotherapy prior to chemoradiotherapy is uncertain. The aim of this randomized, multicentre phase II study is to evaluate the efficacy and safety of chemoradiother...

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Veröffentlicht in:Japanese journal of clinical oncology 2021-02, Vol.51 (2), p.235-243
Hauptverfasser: Ioka, Tatsuya, Furuse, Junji, Fukutomi, Akira, Mizusawa, Junki, Nakamura, Satoaki, Hiraoka, Nobuyoshi, Ito, Yoshinori, Katayama, Hiroshi, Ueno, Makoto, Ikeda, Masafumi, Sugimori, Kazuya, Okano, Naohiro, Shimizu, Kyoko, Yanagimoto, Hiroaki, Okusaka, Takuji, Ozaka, Masato, Todaka, Akiko, Nakamori, Shoji, Tobimatsu, Kazutoshi, Sata, Naohiro, Kawashima, Yohei, Hosokawa, Ayumu, Yamaguchi, Taketo, Miyakawa, Hiroyuki, Hara, Hiroki, Mizuno, Nobumasa, Ishii, Hiroshi
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container_title Japanese journal of clinical oncology
container_volume 51
creator Ioka, Tatsuya
Furuse, Junji
Fukutomi, Akira
Mizusawa, Junki
Nakamura, Satoaki
Hiraoka, Nobuyoshi
Ito, Yoshinori
Katayama, Hiroshi
Ueno, Makoto
Ikeda, Masafumi
Sugimori, Kazuya
Okano, Naohiro
Shimizu, Kyoko
Yanagimoto, Hiroaki
Okusaka, Takuji
Ozaka, Masato
Todaka, Akiko
Nakamori, Shoji
Tobimatsu, Kazutoshi
Sata, Naohiro
Kawashima, Yohei
Hosokawa, Ayumu
Yamaguchi, Taketo
Miyakawa, Hiroyuki
Hara, Hiroki
Mizuno, Nobumasa
Ishii, Hiroshi
description Abstract Background Chemoradiotherapy is a treatment option for locally advanced pancreatic cancer. However, the efficacy of induction chemotherapy prior to chemoradiotherapy is uncertain. The aim of this randomized, multicentre phase II study is to evaluate the efficacy and safety of chemoradiotherapy with and without induction chemotherapy to determine the significance of induction chemotherapy. Methods Patients with locally advanced pancreatic cancer were randomly assigned to the chemoradiotherapy arm (Arm A) or induction chemotherapy followed by the chemoradiotherapy arm (Arm B). Patients in Arm A underwent radiotherapy with concurrent S-1. Patients in Arm B received induction gemcitabine for 12 weeks, and thereafter, only patients with controlled disease underwent the same chemoradiotherapy as Arm A. After chemoradiotherapy, gemcitabine was continued until disease progression or unacceptable toxicity in both arms. The primary endpoint was overall survival. Results Amongst 102 patients enrolled, 100 were eligible for efficacy assessment. The probability of survival was greater in Arm B in the first 12 months, but the trend was reversed in the following periods (1-year survival 66.7 vs. 69.3%, 2-year survival 36.9 vs. 18.9%). The hazard ratio was 1.255 (95% confidence interval 0.816–1.930) in favour of Arm A. Gastrointestinal toxicity was slightly more frequent and three treatment-related deaths occurred in Arm A. Conclusions This study suggested that the chemoradiotherapy using S-1 alone had more promising efficacy with longer-term survival, compared with induction gemcitabine followed by chemoradiotherapy for locally advanced pancreatic cancer. Clinical trial registration The study was registered at the UMIN Clinical Trials Registry as UMIN000006811. Induction gemcitabine followed by chemoradiotherapy was less toxic, although it was associated with poorer long-term survival compared with chemoradiotherapy alone in locally advanced pancreatic cancer.
doi_str_mv 10.1093/jjco/hyaa198
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However, the efficacy of induction chemotherapy prior to chemoradiotherapy is uncertain. The aim of this randomized, multicentre phase II study is to evaluate the efficacy and safety of chemoradiotherapy with and without induction chemotherapy to determine the significance of induction chemotherapy. Methods Patients with locally advanced pancreatic cancer were randomly assigned to the chemoradiotherapy arm (Arm A) or induction chemotherapy followed by the chemoradiotherapy arm (Arm B). Patients in Arm A underwent radiotherapy with concurrent S-1. Patients in Arm B received induction gemcitabine for 12 weeks, and thereafter, only patients with controlled disease underwent the same chemoradiotherapy as Arm A. After chemoradiotherapy, gemcitabine was continued until disease progression or unacceptable toxicity in both arms. The primary endpoint was overall survival. Results Amongst 102 patients enrolled, 100 were eligible for efficacy assessment. The probability of survival was greater in Arm B in the first 12 months, but the trend was reversed in the following periods (1-year survival 66.7 vs. 69.3%, 2-year survival 36.9 vs. 18.9%). The hazard ratio was 1.255 (95% confidence interval 0.816–1.930) in favour of Arm A. Gastrointestinal toxicity was slightly more frequent and three treatment-related deaths occurred in Arm A. Conclusions This study suggested that the chemoradiotherapy using S-1 alone had more promising efficacy with longer-term survival, compared with induction gemcitabine followed by chemoradiotherapy for locally advanced pancreatic cancer. Clinical trial registration The study was registered at the UMIN Clinical Trials Registry as UMIN000006811. Induction gemcitabine followed by chemoradiotherapy was less toxic, although it was associated with poorer long-term survival compared with chemoradiotherapy alone in locally advanced pancreatic cancer.</description><identifier>ISSN: 1465-3621</identifier><identifier>EISSN: 1465-3621</identifier><identifier>DOI: 10.1093/jjco/hyaa198</identifier><identifier>PMID: 33164066</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Chemoradiotherapy - adverse effects ; Deoxycytidine - analogs &amp; derivatives ; Deoxycytidine - therapeutic use ; Female ; Humans ; Induction Chemotherapy - adverse effects ; Japan ; Kaplan-Meier Estimate ; Male ; Medical Oncology ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - therapy ; Progression-Free Survival ; Treatment Outcome</subject><ispartof>Japanese journal of clinical oncology, 2021-02, Vol.51 (2), p.235-243</ispartof><rights>The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2020</rights><rights>The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c385t-23c1b34b301cce9235e6cbee9468f846d4878cc9a28464b93bad7c1c35a760693</citedby><cites>FETCH-LOGICAL-c385t-23c1b34b301cce9235e6cbee9468f846d4878cc9a28464b93bad7c1c35a760693</cites><orcidid>0000-0002-4098-5217 ; 0000-0002-0197-1832</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33164066$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ioka, Tatsuya</creatorcontrib><creatorcontrib>Furuse, Junji</creatorcontrib><creatorcontrib>Fukutomi, Akira</creatorcontrib><creatorcontrib>Mizusawa, Junki</creatorcontrib><creatorcontrib>Nakamura, Satoaki</creatorcontrib><creatorcontrib>Hiraoka, Nobuyoshi</creatorcontrib><creatorcontrib>Ito, Yoshinori</creatorcontrib><creatorcontrib>Katayama, Hiroshi</creatorcontrib><creatorcontrib>Ueno, Makoto</creatorcontrib><creatorcontrib>Ikeda, Masafumi</creatorcontrib><creatorcontrib>Sugimori, Kazuya</creatorcontrib><creatorcontrib>Okano, Naohiro</creatorcontrib><creatorcontrib>Shimizu, Kyoko</creatorcontrib><creatorcontrib>Yanagimoto, Hiroaki</creatorcontrib><creatorcontrib>Okusaka, Takuji</creatorcontrib><creatorcontrib>Ozaka, Masato</creatorcontrib><creatorcontrib>Todaka, Akiko</creatorcontrib><creatorcontrib>Nakamori, Shoji</creatorcontrib><creatorcontrib>Tobimatsu, Kazutoshi</creatorcontrib><creatorcontrib>Sata, Naohiro</creatorcontrib><creatorcontrib>Kawashima, Yohei</creatorcontrib><creatorcontrib>Hosokawa, Ayumu</creatorcontrib><creatorcontrib>Yamaguchi, Taketo</creatorcontrib><creatorcontrib>Miyakawa, Hiroyuki</creatorcontrib><creatorcontrib>Hara, Hiroki</creatorcontrib><creatorcontrib>Mizuno, Nobumasa</creatorcontrib><creatorcontrib>Ishii, Hiroshi</creatorcontrib><creatorcontrib>Hepatobiliary and Pancreatic Oncology Group (HBPOG) of Japan Clinical Oncology Group (JCOG)</creatorcontrib><title>Randomized phase II study of chemoradiotherapy with versus without induction chemotherapy for locally advanced pancreatic cancer: Japan Clinical Oncology Group trial, JCOG1106</title><title>Japanese journal of clinical oncology</title><addtitle>Jpn J Clin Oncol</addtitle><description>Abstract Background Chemoradiotherapy is a treatment option for locally advanced pancreatic cancer. However, the efficacy of induction chemotherapy prior to chemoradiotherapy is uncertain. The aim of this randomized, multicentre phase II study is to evaluate the efficacy and safety of chemoradiotherapy with and without induction chemotherapy to determine the significance of induction chemotherapy. Methods Patients with locally advanced pancreatic cancer were randomly assigned to the chemoradiotherapy arm (Arm A) or induction chemotherapy followed by the chemoradiotherapy arm (Arm B). Patients in Arm A underwent radiotherapy with concurrent S-1. Patients in Arm B received induction gemcitabine for 12 weeks, and thereafter, only patients with controlled disease underwent the same chemoradiotherapy as Arm A. After chemoradiotherapy, gemcitabine was continued until disease progression or unacceptable toxicity in both arms. The primary endpoint was overall survival. Results Amongst 102 patients enrolled, 100 were eligible for efficacy assessment. The probability of survival was greater in Arm B in the first 12 months, but the trend was reversed in the following periods (1-year survival 66.7 vs. 69.3%, 2-year survival 36.9 vs. 18.9%). The hazard ratio was 1.255 (95% confidence interval 0.816–1.930) in favour of Arm A. Gastrointestinal toxicity was slightly more frequent and three treatment-related deaths occurred in Arm A. Conclusions This study suggested that the chemoradiotherapy using S-1 alone had more promising efficacy with longer-term survival, compared with induction gemcitabine followed by chemoradiotherapy for locally advanced pancreatic cancer. Clinical trial registration The study was registered at the UMIN Clinical Trials Registry as UMIN000006811. Induction gemcitabine followed by chemoradiotherapy was less toxic, although it was associated with poorer long-term survival compared with chemoradiotherapy alone in locally advanced pancreatic cancer.</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Chemoradiotherapy - adverse effects</subject><subject>Deoxycytidine - analogs &amp; derivatives</subject><subject>Deoxycytidine - therapeutic use</subject><subject>Female</subject><subject>Humans</subject><subject>Induction Chemotherapy - adverse effects</subject><subject>Japan</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical Oncology</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Staging</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Neoplasms - therapy</subject><subject>Progression-Free Survival</subject><subject>Treatment Outcome</subject><issn>1465-3621</issn><issn>1465-3621</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9LxDAQxYMo_r95lrl5cTXZtNnWmyy6rggLoucynaQ2S7cpSavUL-VXtOuqePI0bx4_3jCPsRPBLwRP5eVySe6y7BFFmmyxfRGpeCTVWGz_0XvsIIQl5zxOosku25NSqIgrtc8-HrHWbmXfjYamxGBgPofQdroHVwCVZuU8auva0nhsenizbQmvxocufGnXtWBr3VFrXb3hf9DCeagcYVX1gPoVa1rfGIY32FoCWjv-Cu5xMGFa2doOMCxqcpV76WHmXddA6y1W53A_XcyE4OqI7RRYBXP8PQ_Z8-3N0_Ru9LCYzafXDyOSSdyOxpJELqNcckFk0rGMjaLcmDRSSZFESkfJJCFKcTwsUZ7KHPWEBMkYJ4qrVB6y800ueReCN0XWeLtC32eCZ-ves3Xv2XfvA366wZsuXxn9C_8UPQBnG2D46f-oT7gfkR4</recordid><startdate>20210208</startdate><enddate>20210208</enddate><creator>Ioka, Tatsuya</creator><creator>Furuse, Junji</creator><creator>Fukutomi, Akira</creator><creator>Mizusawa, Junki</creator><creator>Nakamura, Satoaki</creator><creator>Hiraoka, Nobuyoshi</creator><creator>Ito, Yoshinori</creator><creator>Katayama, Hiroshi</creator><creator>Ueno, Makoto</creator><creator>Ikeda, Masafumi</creator><creator>Sugimori, Kazuya</creator><creator>Okano, Naohiro</creator><creator>Shimizu, Kyoko</creator><creator>Yanagimoto, Hiroaki</creator><creator>Okusaka, Takuji</creator><creator>Ozaka, Masato</creator><creator>Todaka, Akiko</creator><creator>Nakamori, Shoji</creator><creator>Tobimatsu, Kazutoshi</creator><creator>Sata, Naohiro</creator><creator>Kawashima, Yohei</creator><creator>Hosokawa, Ayumu</creator><creator>Yamaguchi, Taketo</creator><creator>Miyakawa, Hiroyuki</creator><creator>Hara, Hiroki</creator><creator>Mizuno, Nobumasa</creator><creator>Ishii, Hiroshi</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0002-4098-5217</orcidid><orcidid>https://orcid.org/0000-0002-0197-1832</orcidid></search><sort><creationdate>20210208</creationdate><title>Randomized phase II study of chemoradiotherapy with versus without induction chemotherapy for locally advanced pancreatic cancer: Japan Clinical Oncology Group trial, JCOG1106</title><author>Ioka, Tatsuya ; Furuse, Junji ; Fukutomi, Akira ; Mizusawa, Junki ; Nakamura, Satoaki ; Hiraoka, Nobuyoshi ; Ito, Yoshinori ; Katayama, Hiroshi ; Ueno, Makoto ; Ikeda, Masafumi ; Sugimori, Kazuya ; Okano, Naohiro ; Shimizu, Kyoko ; Yanagimoto, Hiroaki ; Okusaka, Takuji ; Ozaka, Masato ; Todaka, Akiko ; Nakamori, Shoji ; Tobimatsu, Kazutoshi ; Sata, Naohiro ; Kawashima, Yohei ; Hosokawa, Ayumu ; Yamaguchi, Taketo ; Miyakawa, Hiroyuki ; Hara, Hiroki ; Mizuno, Nobumasa ; Ishii, Hiroshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c385t-23c1b34b301cce9235e6cbee9468f846d4878cc9a28464b93bad7c1c35a760693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Chemoradiotherapy - adverse effects</topic><topic>Deoxycytidine - analogs &amp; derivatives</topic><topic>Deoxycytidine - therapeutic use</topic><topic>Female</topic><topic>Humans</topic><topic>Induction Chemotherapy - adverse effects</topic><topic>Japan</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical Oncology</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Staging</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pancreatic Neoplasms - therapy</topic><topic>Progression-Free Survival</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ioka, Tatsuya</creatorcontrib><creatorcontrib>Furuse, Junji</creatorcontrib><creatorcontrib>Fukutomi, Akira</creatorcontrib><creatorcontrib>Mizusawa, Junki</creatorcontrib><creatorcontrib>Nakamura, Satoaki</creatorcontrib><creatorcontrib>Hiraoka, Nobuyoshi</creatorcontrib><creatorcontrib>Ito, Yoshinori</creatorcontrib><creatorcontrib>Katayama, Hiroshi</creatorcontrib><creatorcontrib>Ueno, Makoto</creatorcontrib><creatorcontrib>Ikeda, Masafumi</creatorcontrib><creatorcontrib>Sugimori, Kazuya</creatorcontrib><creatorcontrib>Okano, Naohiro</creatorcontrib><creatorcontrib>Shimizu, Kyoko</creatorcontrib><creatorcontrib>Yanagimoto, Hiroaki</creatorcontrib><creatorcontrib>Okusaka, Takuji</creatorcontrib><creatorcontrib>Ozaka, Masato</creatorcontrib><creatorcontrib>Todaka, Akiko</creatorcontrib><creatorcontrib>Nakamori, Shoji</creatorcontrib><creatorcontrib>Tobimatsu, Kazutoshi</creatorcontrib><creatorcontrib>Sata, Naohiro</creatorcontrib><creatorcontrib>Kawashima, Yohei</creatorcontrib><creatorcontrib>Hosokawa, Ayumu</creatorcontrib><creatorcontrib>Yamaguchi, Taketo</creatorcontrib><creatorcontrib>Miyakawa, Hiroyuki</creatorcontrib><creatorcontrib>Hara, Hiroki</creatorcontrib><creatorcontrib>Mizuno, Nobumasa</creatorcontrib><creatorcontrib>Ishii, Hiroshi</creatorcontrib><creatorcontrib>Hepatobiliary and Pancreatic Oncology Group (HBPOG) of Japan Clinical Oncology Group (JCOG)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Japanese journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ioka, Tatsuya</au><au>Furuse, Junji</au><au>Fukutomi, Akira</au><au>Mizusawa, Junki</au><au>Nakamura, Satoaki</au><au>Hiraoka, Nobuyoshi</au><au>Ito, Yoshinori</au><au>Katayama, Hiroshi</au><au>Ueno, Makoto</au><au>Ikeda, Masafumi</au><au>Sugimori, Kazuya</au><au>Okano, Naohiro</au><au>Shimizu, Kyoko</au><au>Yanagimoto, Hiroaki</au><au>Okusaka, Takuji</au><au>Ozaka, Masato</au><au>Todaka, Akiko</au><au>Nakamori, Shoji</au><au>Tobimatsu, Kazutoshi</au><au>Sata, Naohiro</au><au>Kawashima, Yohei</au><au>Hosokawa, Ayumu</au><au>Yamaguchi, Taketo</au><au>Miyakawa, Hiroyuki</au><au>Hara, Hiroki</au><au>Mizuno, Nobumasa</au><au>Ishii, Hiroshi</au><aucorp>Hepatobiliary and Pancreatic Oncology Group (HBPOG) of Japan Clinical Oncology Group (JCOG)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized phase II study of chemoradiotherapy with versus without induction chemotherapy for locally advanced pancreatic cancer: Japan Clinical Oncology Group trial, JCOG1106</atitle><jtitle>Japanese journal of clinical oncology</jtitle><addtitle>Jpn J Clin Oncol</addtitle><date>2021-02-08</date><risdate>2021</risdate><volume>51</volume><issue>2</issue><spage>235</spage><epage>243</epage><pages>235-243</pages><issn>1465-3621</issn><eissn>1465-3621</eissn><abstract>Abstract Background Chemoradiotherapy is a treatment option for locally advanced pancreatic cancer. However, the efficacy of induction chemotherapy prior to chemoradiotherapy is uncertain. The aim of this randomized, multicentre phase II study is to evaluate the efficacy and safety of chemoradiotherapy with and without induction chemotherapy to determine the significance of induction chemotherapy. Methods Patients with locally advanced pancreatic cancer were randomly assigned to the chemoradiotherapy arm (Arm A) or induction chemotherapy followed by the chemoradiotherapy arm (Arm B). Patients in Arm A underwent radiotherapy with concurrent S-1. Patients in Arm B received induction gemcitabine for 12 weeks, and thereafter, only patients with controlled disease underwent the same chemoradiotherapy as Arm A. After chemoradiotherapy, gemcitabine was continued until disease progression or unacceptable toxicity in both arms. The primary endpoint was overall survival. Results Amongst 102 patients enrolled, 100 were eligible for efficacy assessment. The probability of survival was greater in Arm B in the first 12 months, but the trend was reversed in the following periods (1-year survival 66.7 vs. 69.3%, 2-year survival 36.9 vs. 18.9%). The hazard ratio was 1.255 (95% confidence interval 0.816–1.930) in favour of Arm A. Gastrointestinal toxicity was slightly more frequent and three treatment-related deaths occurred in Arm A. Conclusions This study suggested that the chemoradiotherapy using S-1 alone had more promising efficacy with longer-term survival, compared with induction gemcitabine followed by chemoradiotherapy for locally advanced pancreatic cancer. Clinical trial registration The study was registered at the UMIN Clinical Trials Registry as UMIN000006811. Induction gemcitabine followed by chemoradiotherapy was less toxic, although it was associated with poorer long-term survival compared with chemoradiotherapy alone in locally advanced pancreatic cancer.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>33164066</pmid><doi>10.1093/jjco/hyaa198</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-4098-5217</orcidid><orcidid>https://orcid.org/0000-0002-0197-1832</orcidid><oa>free_for_read</oa></addata></record>
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source Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection
subjects Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Chemoradiotherapy - adverse effects
Deoxycytidine - analogs & derivatives
Deoxycytidine - therapeutic use
Female
Humans
Induction Chemotherapy - adverse effects
Japan
Kaplan-Meier Estimate
Male
Medical Oncology
Middle Aged
Multivariate Analysis
Neoplasm Staging
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - therapy
Progression-Free Survival
Treatment Outcome
title Randomized phase II study of chemoradiotherapy with versus without induction chemotherapy for locally advanced pancreatic cancer: Japan Clinical Oncology Group trial, JCOG1106
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