Initial systemic chemotherapy ( 6 months ) with a combination regimen is recommended for most patients ( for some patients radiation therapy may be offered up front ) with Eastern Cooperative Oncology Group performance status 0 or 1 and a favorable comorbidity profile .
There is no clear evidence to support one regimen over another .
PURPOSE To provide evidence -based recommendations to oncologists and others for treatment of patients with locally advanced , unresectable pancreatic cancer .
Concurrent chemoradiotherapy treatment of locally advanced pancreatic cancer: gemcitabine versus 5-fluorouracil, a randomized controlled study.
PURPOSE To determine the efficacy and tolerability of gemcitabine (GEM)-concurrent chemoradiotherapy ( CCRT ) vs. 5-fluorouracil ( 5-FU ) CCRT for locally advanced pancreatic cancer . METHODS AND MATERIAL S Thirty-four patients with locally advanced pancreatic cancer were studied . Eighteen patients were r and omized to receive GEM CCRT ( 600 mg/m(2)/wk for 6 weeks ) and 16 patients to receive bolus 5-FU CCRT ( 500 mg/m(2)/d for 3 days repeated every 2 weeks for 6 weeks ) . All patients were to receive 3D-CRT 50.4 - 61.2 Gy at 1.8-Gy/d fractions and GEM ( 1000 mg/m(2 ) weekly for 3 weeks repeated every 4 weeks ) after RT . RESULTS The median survival and median time to progression were 14.5 months and 7.1 months for the GEM CCRT group and 6.7 months and 2.7 months for the 5-FU CCRT group ( p = 0.027 and p = 0.019 , respectively ) . The quality -adjusted life month survival time was 11.2 + /- 0.5 months for GEM CCRT and 6.0 + /- 0.3 months for 5-FU CCRT patients ( p < 0.001 ) . The response rate was 50 % ( four complete responses and five partial responses ) for GEM CCRT and 13 % ( two partial responses ) for 5-FU CCRT ( p = 0.005 ) . Pain control was 39 % for GEM CCRT and 6 % for 5-FU CCRT ( p = 0.043 ) . Grade 3 - 4 neutropenia ( 34 % vs. 19 % ) , thrombocytopenia ( 0 % vs. 7 % ) , nausea ( 33 % vs. 31 % ) , vomiting ( 17 % vs. 19 % ) , hospitalization days per month of survival ( 7.4 + /- 1.7 days vs. 8.0 + /- 1.3 days ) , and full dose of RT received ( 78 % vs. 75 % ) were not significantly different between the GEM CCRT and 5-FU CCRT patients . CONCLUSION GEM CCRT appears more effective than 5-FU CCRT for locally advanced pancreatic cancer and has comparable tolerability
Initial systemic chemotherapy ( 6 months ) with a combination regimen is recommended for most patients ( for some patients radiation therapy may be offered up front ) with Eastern Cooperative Oncology Group performance status 0 or 1 and a favorable comorbidity profile .
There is no clear evidence to support one regimen over another .
PURPOSE To provide evidence -based recommendations to oncologists and others for treatment of patients with locally advanced , unresectable pancreatic cancer .