Efficacy of gemcitabine for locally advanced pancreatic cancer: comparison with 5-fluorouracil-based chemoradiotherapy.
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.
Tada
Minoru
M
Department of Gastroenterology, University of Tokyo, Tokyo, Japan. mtada-tky@umin.ac.jp
Arizumi
Toshihiko
T
Arizumi
Masatoshi
M
Nakai
Yousuke
Y
Sasaki
Takashi
T
Kogure
Hirofumi
H
Togawa
Osamu
O
Matsubara
Saburo
S
Tsujino
Takeshi
T
Hirano
Kenji
K
Sasahira
Naoki
N
Isayama
Hiroyuki
H
Kawabe
Takao
T
Omata
Masao
M
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
D000970:Antineoplastic Agents; D003841:Deoxycytidine; D005472:Fluorouracil; D000093542:Gemcitabine