الفهرس 
Table of contentsOnly 14 pages are availabe for public view
 |  | from | 129 |  |  |
| | | from | 129 | | |
Abstract
pancreatic cancer accounts for only 2% of all cancer diagnoses, it is the fourth leading cause of cancer death and one of the most difficult malignancies to manage. About 15 to 20% of PC patients presented with resectable stage at diagnosis. Surgery is necessary for the long term survival of patients with localized pancreatic cancer but it is clearly insufficient. There is no standard treatment for patients with pancreatic carcinoma in the adjuvant setting. The aim of this study was to determine the efficacy (as disease free survival, and overall survival), tolerability and toxicity profile of chemoradiotherapy versus chemotherapy only. This is a prospective study with historical control group on patients with operable pancreatic head carcinoma underwent Whipple surgery and attended to Clinical Oncology and Nuclear Medicine Department - Mansoura University Hospitals, from February 2014 to March 2016 with adjuvant CRT treatment and historical group within previous 2 years from February 2012 to January 2014 was treated with CTH was assessed through this study. The analysis for this study was done to assess survival significance after follow of patients for at least 6 months for the last patient and result in median DFS was19 months for the CRT group and 13 months in the CTH group which was statistically significant (P value = 0.041).The median OAS is 27 months in the CRT group in comparison to 19 months for the CTH group which was statistically significant (P value = 0.023). As regards the toxicity assessment of our study, both arms of the study were well tolerated. The most common toxicity during CRT phase was anemia, fatigue, abdominal pain, diarrhea and hand and foot syndrome. No patients needed to interrupt the treatment. In conclusion, concurrent CRT using capecitabine based 3DCRTwith initial and subsequent systemic gemcitabine is tolerable, feasible, and effective, and offers good local control for a substantial proportion of patients after whipple surgery than chemotherapy (gemcitabine) only. This protocol showed a significantly better DFS, OAS and accepted toxicity profile in comparison with other regimen. However, further studies with larger numbers of patients are needed to confirm our finding.