TY - JOUR
T1 - Gemcitabine as first-line chemotherapy in elderly patients with unresectable pancreatic carcinoma
AU - Yamagishi, Yoshiyuki
AU - Higuchi, Hajime
AU - Izumiya, Motoko
AU - Sakai, Gen
AU - Iizuka, Hideko
AU - Nakamura, Shoko
AU - Adachi, Masayuki
AU - Hozawa, Sigenari
AU - Takaishi, Hiromasa
AU - Hibi, Toshifumi
N1 - Funding Information:
This study was supported by grants from the Japanese Ministry of Education, Science, and Culture, and by a Keio University Grant-in-Aid for Encouragement of Young Medical Scientists.
PY - 2010/11
Y1 - 2010/11
N2 - Gemcitabine (GEM) is the key drug for the chemotherapy of unresectable pancreatic cancer. However, the efficacy and safety of GEM has not been established in elderly patients. We retrospectively examined the prognosis of elderly pancreatic cancer patients treated with GEM. Methods Sixty-six patients with unresectable pancreatic cancer (pathologically identified) and no prior chemotherapy were divided into three groups. Group A: patients aged 70 years or more who received standard GEM (1000 mg/m2) on days 1, 8, and 15 and rest on day 21; Group B: patients less than 70 years old who received standard GEM therapy; and Group C: patients under best supportive care. Results Median survival times (MSTs) (days) were 311 in group A (p<0.05 vs. group C), 292 in group B (p<0.05 vs. group C), and 127 in group C.Amongthe patientswho received GEM, 23% patients in group A and 16% patients in group B obtained partial responses. The response rates andMSTs were similar in groupsAandB, aswell as in more aged (≥75 years) patients. Bone marrow suppression was more frequently seen in elderly patients. Cox's hazard model in patients aged 70 years or more revealed that GEM therapy reduced the hazard ratio for death (hazard ratio: 0.683, p = 0.041). Conclusions Chemotherapy with GEM appears to be effective and safe in elderly patients as well as in younger patients. Patients with unresectable pancreatic carcinoma should receive GEM therapy even if they are aged 70 or more, even if they are aged 75 or more.
AB - Gemcitabine (GEM) is the key drug for the chemotherapy of unresectable pancreatic cancer. However, the efficacy and safety of GEM has not been established in elderly patients. We retrospectively examined the prognosis of elderly pancreatic cancer patients treated with GEM. Methods Sixty-six patients with unresectable pancreatic cancer (pathologically identified) and no prior chemotherapy were divided into three groups. Group A: patients aged 70 years or more who received standard GEM (1000 mg/m2) on days 1, 8, and 15 and rest on day 21; Group B: patients less than 70 years old who received standard GEM therapy; and Group C: patients under best supportive care. Results Median survival times (MSTs) (days) were 311 in group A (p<0.05 vs. group C), 292 in group B (p<0.05 vs. group C), and 127 in group C.Amongthe patientswho received GEM, 23% patients in group A and 16% patients in group B obtained partial responses. The response rates andMSTs were similar in groupsAandB, aswell as in more aged (≥75 years) patients. Bone marrow suppression was more frequently seen in elderly patients. Cox's hazard model in patients aged 70 years or more revealed that GEM therapy reduced the hazard ratio for death (hazard ratio: 0.683, p = 0.041). Conclusions Chemotherapy with GEM appears to be effective and safe in elderly patients as well as in younger patients. Patients with unresectable pancreatic carcinoma should receive GEM therapy even if they are aged 70 or more, even if they are aged 75 or more.
KW - CA19-9
KW - Dupan-2
KW - Elderly
KW - Gemcitabine
KW - Neoplasm
KW - Pancreas
KW - Unresectable
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U2 - 10.1007/s00535-010-0258-9
DO - 10.1007/s00535-010-0258-9
M3 - Article
C2 - 20549255
AN - SCOPUS:78651275179
VL - 45
SP - 1146
EP - 1154
JO - Journal of Gastroenterology
JF - Journal of Gastroenterology
SN - 0944-1174
IS - 11
ER -
