Gemcitabine versus gemcitabine combined with cisplatin treatment locally advanced or metastatic pancreatic cancer: a retrospective analysis.
OBJECTIVE
Gemcitabine is the most active agent to treat unresectable pancreatic cancer. The superiority of combining other drugs with cisplatin is still controversial; therefore, we performed a retrospective analysis of gemcitabine versus gemcitabine combined with cisplatin to determine the treatment outcomes for patients with locally advanced or metastatic pancreatic cancer.


METHODS
From 2001 to 2007, we enrolled 60 patients who were treated with gemcitabine or gemcitabine combined with cisplatin for locally advanced or metastatic pancreatic cancer. Gemcitabine 1, 000 mg/m(2) (G) was administrated at day 1 and day 8 every 3 weeks. Cisplatin 60 mg/m(2) was added at day 1 every 3 weeks to the gemcitabine schedule (GP).


RESULTS
NUMBER OF G: GP was 34: 26, locally advanced to metastatic ratio was 35% to 65% in group G and 46% to 54% in group GP. Median follow up duration was 29 months. The median number of chemotherapy cycles was 4 (range: 2 approximately 11) for the G group, and 4 (range: 1 approximately 11) for the GP group. The response rate of the G and GP groups was 17% and 11%, respectively. The progression free survival (PFS) was 4.5 months and 2.8 months, respectively, for the G and GP groups. The overall survival (OS) was 10.7 and 8.7 months respectively, for the G and GP groups, but there is no statistically significant difference of the PFS (p=0.2396) and OS (p=0.4643) between the 2 groups. The hematological toxicity profile was similar (the grade III neutropenia and thrombocytopenia was 4.4% and 3.1%, respectively, in G group, and 7.5% and 2.8%, respectively, in the GP group). But non-hematological toxicities such as skin rash, abnormal liver function and nausea/vomiting were observed in 3 patients of the GP group. On the prognostic factor analysis, no factors predicted a longer PFS and OS for both the G and GP groups.


CONCLUSIONS
Gemcitabine single treatment might be more tolerable and it had the same efficacy compared to cisplatin combination treatment in this retrospective study.
Choi
Jae-Hyuk
JH
Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
Oh
Sung Yong
SY
Kwon
Hyuk-Chan
HC
Kim
Jung Hwan
JH
Lee
Jae Hoon
JH
Lee
Suee
S
Lee
Dong Mee
DM
Kim
Sung-Hyun
SH
Rho
Myung Hwan
MH
Kim
Young-Hoon
YH
Rho
Mee-Sook
MS
Kim
Hyo-Jin
HJ
Cancer. 1999 Mar 15;85(6):1261-8
10189130
J Clin Oncol. 2007 May 20;25(15):1960-6
17452677
Ann Oncol. 1996 Apr;7(4):347-53
8805925
J Clin Oncol. 2007 Jun 1;25(16):2212-7
17538165
Ann Oncol. 1996 Aug;7(6):593-600
8879373
World J Gastroenterol. 2006 Nov 21;12(43):6973-81
17109519
Cancer Res Treat. 2004 Apr;36(2):103-14
20396549
Cancer. 2002 Feb 15;94(4):902-10
11920457
J Natl Cancer Inst. 2000 Feb 2;92(3):205-16
10655437
J Clin Oncol. 1997 Jun;15(6):2403-13
9196156
Langenbecks Arch Surg. 2002 Mar;386(8):570-4
11914932
Clin Cancer Res. 1996 Mar;2(3):521-30
9816199
Eur J Cancer. 1993;29A(2):203-4
8422283
Semin Oncol. 1997 Apr;24(2 Suppl 7):S7-8-S7-16
9194474
Br J Surg. 1994 Jun;81(6):882-5
8044610