Prognostic factors in patients with locally advanced pancreatic carcinoma receiving chemoradiotherapy.
BACKGROUND
The combination of radiation therapy and chemotherapy (chemoradiotherapy [CRT]) has been accepted as standard therapy for patients with locally advanced pancreatic carcinoma (PC). This study investigated prognostic factors in patients with locally advanced PC receiving CRT.


METHODS
Fifty-five consecutive patients with locally advanced PC, who received concurrent radiotherapy (50.4 grays) and chemotherapy using 5-fluorouracil or cisplatin, were analyzed retrospectively to investigate prognostic factors.


RESULTS
Median survival time and overall survival rates at 1 and 2 years were 301 days, 35.1% and 2.4%, respectively. By multivariate analysis using the Cox proportional hazards model, performance status of 0-1 (P < 0.01), absence of regional lymph node swelling (P < 0.01), and serum CA 19-9 level of less than 1000 (P = 0.02) were independent favorable prognostic factors. A prognostic index based on the coefficients of those prognostic factors was used to classify patients into three groups with good, intermediate, and poor prognoses. The median survival times for these three groups were 410, 239, and 143 days, respectively (P < 0.01).


CONCLUSIONS
The results may be helpful in predicting life expectancy, determining treatment strategies, and designing future clinical trials.
Ikeda
M
M
Hepatobiliary and Pancreatic Oncology Division, National Cancer Center Hospital, Tsukiji, Chuo-ku, Tokyo, Japan.
Okada
S
S
Tokuuye
K
K
Ueno
H
H
Okusaka
T
T
D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002945:Cisplatin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D002945:Cisplatin; D005472:Fluorouracil