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 .
Health-Related Quality of Life in SCALOP, a Randomized Phase 2 Trial Comparing Chemoradiation Therapy Regimens in Locally Advanced Pancreatic Cancer
Purpose Chemoradiation therapy ( CRT ) for patients with locally advanced pancreatic cancer ( LAPC ) provides survival benefits but may result in considerable toxicity . Health-related quality of life ( HRQL ) measurements during CRT have not been widely reported . This paper reports HRQL data from the Selective Chemoradiation in Advanced Localised Pancreatic Cancer ( SCALOP ) trial , including validation of the QLQ-PAN26 tool in CRT . Methods and Material s Patients with locally advanced , inoperable , nonmetastatic carcinoma of the pancreas were eligible . Following 12 weeks of induction gemcitabine plus capecitabine ( GEMCAP ) chemotherapy , patients with stable and responding disease were r and omized to a further cycle of GEMCAP followed by capecitabine- or gemcitabine-based CRT .  HRQL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Question naire ( EORTC QLQ-C30 ) and the EORTC Pancreatic Cancer module ( PAN26 ) . Results A total of 114 patients from 28 UK centers were registered and 74 patients r and omized . There was improvement in the majority of HRQL scales during induction chemotherapy . Patients with significant deterioration in fatigue , appetite loss , and gastrointestinal symptoms during CRT recovered within 3 weeks following CRT . Differences in changes in HRQL scores between trial arms rarely reached statistical significance ; however , where they did , they favored capecitabine therapy . PAN26 scales had good internal consistency and were able to distinguish between subgroups of patients experiencing toxicity . Conclusions Although there is deterioration in HRQL following CRT , this resolves within 3 weeks . HRQL data support the use of capecitabine- over gemcitabine-based chemoradiation . The QLQ-PAN26 is a reliable and valid tool for use in patients receiving CRT
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 .