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Treatment Combo for Pancreatic Cancer Has Limited Benefit

Chemo/chemoradiation therapy extended survival but not significantly

TUESDAY, March 4 (HealthDay News) -- In patients who had surgery for pancreatic cancer, adding the chemotherapy drug gemcitabine to chemoradiation prolonged survival, but the improvement was not statistically significant, a new study finds.

Among patients who have surgery to remove pancreatic cancer, there is a 50 percent to 85 percent rate of local relapse and a five-year survival rate of less than 20 percent, according to background information in the study.

This makes the combination of added postoperative chemotherapy and radiation an important consideration. Previous research has shown that gemcitabine is more effective than the drug fluorouracil at improving patient outcomes.

This study examined whether the addition of gemcitabine to the supplemental treatment of fluorouracil chemoradiation improved survival in patients who had a portion of their pancreas removed as a treatment for pancreatic cancer.

During the study, the 451 patients received either chemotherapy with gemcitabine (221) or with fluorouracil (230) for three weeks prior to chemoradiation therapy and for 12 weeks after chemoradiation therapy (with fluorouracil).

Among the 388 patients with pancreatic head tumors, those in the gemcitabine group had a median (midpoint) survival of 20.5 months and a three-year survival rate of 31 percent, compared to 16.9 months and 22 percent among those in the fluorouracil group. The rates of certain level (grade 4) of hematologic (abnormalities in blood cell counts) toxicity were 1 percent in the fluorouracil group and 14 percent in the gemcitabine group.

There were no differences in neutropenia (a blood disorder), infection, or in the ability to complete chemotherapy or radiation therapy.

"The addition of gemcitabine to (supplemental) fluorouracil-based chemoradiation was associated with a survival benefit for patients with resected pancreatic cancer, although this improvement was not statistically significant," the study authors concluded.

The study was published in the March 5 issue of the Journal of the American Medical Association.

More information

The American Cancer Society has more about pancreatic cancer.

-- Robert Preidt

SOURCE: Journal of the American Medical Association, news release, March 4, 2008

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