Efficacy of gemcitabine for locally advanced pancreatic cancer: Comparison with 5-fluorouracil-based chemoradiotherapy

Background: The efficacy of gemcitabine alone has not been established in comparison with conventional chemoradiotherapy for locally advanced pancreatic cancer. Methods: Of 180 consecutive patients with unresectable advanced pancreatic cancer, 93 were locally advanced. Among these 93 patients, 45 were treated with gemcitabine, 18 with concurrent radiotherapy and 5-fluorouracil-based chemotherapy, and 30 received best supportive care (BSC). In cases of metastatic disease, 42 were treated with gemcitabine and 32 received BSC. Overall survival and adverse events were analyzed retrospectively. Results: Median survival time and 1-year survival rate were 11.6, 9.3, 6.7, 7.8 and 2.4 months and 47, 39, 27, 21 and 7% in the groups of gemcitabine, chemoradiotherapy, BSC of locally advanced cancer, and in those of gemcitabine, BSC of metastatic disease, respectively. Gemcitabine and chemoradiotherapy prolonged overall survival time compared with BSC (p = 0.0071). No significant difference in survival was observed between gemcitabine and chemoradiotherapy for locally advanced cases. Adverse events 1 grade 3 were observed in 25 of 87 (29%) of gemcitabine-treated and in 3 of 18 (17%) of chemoradiotherapy-treated patients. Conclusion: Gemcitabine monotherapy for locally advanced pancreatic cancer could be as effective as previous chemoradiotherapy. Copyright (C) 2008 S. Karger AG, Basel.