Gemcitabine Treatment in Pancreatic Cancer - Prognostic Factors and Outcome
Background: Pancreatic cancer is generally associated with
a poor prognosis and often diagnosed in an advanced stage.
The aim of the present study was to evaluate gemcitabine
treatment concerning prognostic factors, clinical benefit, tolerance/
toxicity and survival. Methods: Patients with surgically
nonresectable, locally advanced or metastatic pancreatic
cancer treated with gemcitabine were included. Different
parameters, including clinical benefit, toxicity (WHOÎ„s criteria)
and survival were registered. Kaplan-Meier and Cox
regression analysis were performed. Results: Forty-two consecutive
patients were included. Median age was 62.5 years,
42% were men. Gemcitabine treatment lasted in median for 5
months (0.5-29 months). Median survival from diagnosis was
9.4 months and from start of treatment 8.1 months. Thirteen
patients (32%) were alive 12 months after treatment start.
The treatment was overall well tolerated concerning toxicity.
Seven patients had transient grade 4 reactions. Of 8 parameters
selected from the univariate analysis, 3 were identified
as independent predictors for longer survival: age >60
years, â‰¤5 % weight loss at diagnosis and absence of metastases.
Conclusions: Gemcitabine treatment in locally advanced
and metastatic pancreatic cancer showed to be of potential
benefit and well tolerated. Age, weight loss and metastases
were independent prognostic factors for survival. The median
survival time was longer than previously reported.
Keywords: pancreatic cancer; locally advanced; gemcitabine;
treatment outcome; prognostic factors