title: Impact of gemcitabine chemotherapy and 3-dimensional conformal radiation therapy/5-fluorouracil on quality of life of patients managed for pancreatic cancer.
abstract: OBJECTIVE
  To report quality of life (QOL) results for patients receiving chemoradiation therapy for pancreatic cancer.
  
  
  METHODS
  Eligible patients (n=41 locally advanced, n=22 postsurgery) entered the B9E-AY-S168 study and received 1 cycle of induction gemcitabine (1000 mg/m2 weekly ×3 with 1-week break) followed by 3-dimensional conformal radiation therapy (RT) (54 Gy locally advanced and 45 Gy postsurgery) and concomitant continuous-infusion 5-fluorouracil (5FU) (200 mg/m2/d throughout RT). After 4 weeks, patients received an additional 3 cycles of consolidation gemcitabine chemotherapy. Patients completed the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-PAN26 questionnaires at baseline, before RT/5FU, at end of RT/5FU, before consolidation gemcitabine, and at treatment completion.
  
  
  RESULTS
  The patterns of change in global QOL scores differed between groups. In the locally advanced group global QOL scores were +13, +8, +3, and +1 compared with baseline before RT/5FU (P=.008), at end of RT/5FU, before consolidation gemcitabine, and at treatment completion, respectively. In the postsurgery group, global QOL scores were -3, +4, +15, and +17 compared with baseline at the same time points, with a significant improvement in global QOL before consolidation gemcitabine (P=.03). No significant declines in global QOL were reported by either cohort.
  
  
  CONCLUSIONS
  This study demonstrates that global QOL and associated function and symptom profiles for pancreatic chemoradiation therapy differ between locally advanced and postsurgery patients, likely owing to differences in underlying disease status. For both groups, the treatment protocol was well tolerated and did not have a negative impact on patients' global QOL.
authors.affiliation: Discipline of Medical Radiation Sciences, University of Sydney, and Department of Medical Oncology, Prince of Wales Hospital, Sydney, New South Wales, Australia.
authors.forename: Michala
authors.initials: M
authors.lastname: Short
authors.forename: David
authors.initials: D
authors.lastname: Goldstein
authors.forename: Georgia
authors.initials: G
authors.lastname: Halkett
authors.forename: William
authors.initials: W
authors.lastname: Reece
authors.forename: Martin
authors.initials: M
authors.lastname: Borg
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Zissiadis
authors.forename: Andrew
authors.initials: A
authors.lastname: Kneebone
authors.forename: Nigel
authors.initials: N
authors.lastname: Spry
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D059248:Chemoradiotherapy / Q000379:methods*; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use*; D020266:Radiotherapy, Conformal / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D011838:Radiation-Sensitizing Agents; D003841:Deoxycytidine; D005472:Fluorouracil; D000093542:Gemcitabine