title: Efficacy of gemcitabine for locally advanced pancreatic cancer: comparison with 5-fluorouracil-based chemoradiotherapy.
abstract: BACKGROUND
  The efficacy of gemcitabine alone has not been established in comparison with conventional chemoradiotherapy for locally advanced pancreatic cancer.
  
  
  METHODS
  Of 180 consecutive patients with unresectable advanced pancreatic cancer, 93 were locally advanced. Among these 93 patients, 45 were treated with gemcitabine, 18 with concurrent radiotherapy and 5-fluorouracil-based chemotherapy, and 30 received best supportive care (BSC). In cases of metastatic disease, 42 were treated with gemcitabine and 32 received BSC. Overall survival and adverse events were analyzed retrospectively.
  
  
  RESULTS
  Median survival time and 1-year survival rate were 11.6, 9.3, 6.7, 7.8 and 2.4 months and 47, 39, 27, 21 and 7% in the groups of gemcitabine, chemoradiotherapy, BSC of locally advanced cancer, and in those of gemcitabine, BSC of metastatic disease, respectively. Gemcitabine and chemoradiotherapy prolonged overall survival time compared with BSC (p = 0.0071). No significant difference in survival was observed between gemcitabine and chemoradiotherapy for locally advanced cases. Adverse events >grade 3 were observed in 25 of 87 (29%) of gemcitabine-treated and in 3 of 18 (17%) of chemoradiotherapy-treated patients.
  
  
  CONCLUSIONS
  Gemcitabine monotherapy for locally advanced pancreatic cancer could be as effective as previous chemoradiotherapy.
authors.affiliation: Department of Gastroenterology, University of Tokyo, Tokyo, Japan. mtada-tky@umin.ac.jp
authors.forename: Minoru
authors.initials: M
authors.lastname: Tada
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Arizumi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Arizumi
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Nakai
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasaki
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kogure
authors.forename: Osamu
authors.initials: O
authors.lastname: Togawa
authors.forename: Saburo
authors.initials: S
authors.lastname: Matsubara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsujino
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirano
authors.forename: Naoki
authors.initials: N
authors.lastname: Sasahira
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: Takao
authors.initials: T
authors.lastname: Kawabe
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000532:radiotherapy; D015996:Survival Rate; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D003841:Deoxycytidine; D005472:Fluorouracil; D000093542:Gemcitabine