Open AccessSurvival outcomes in patients with early stage, resected pancreatic cancer – a comparison of gemcitabine‐ and 5‐fluorouracil‐based chemotherapy and chemoradiation regimens
Author(s) -
Kizilbash S. H.,
Ward K. C.,
Liang J. J.,
Jaiyesimi I.,
Lipscomb J.
Publication year - 2014
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.12353
Subject(s) - gemcitabine , medicine , fluorouracil , chemotherapy , pancreatic cancer , radiation therapy , oncology , antimetabolite , chemoradiotherapy , stage (stratigraphy) , cancer , surgery , gastroenterology , paleontology , biology
Summary Purpose We conducted a comparative survival analysis between patients with resected pancreatic cancer who received adjuvant treatment with either gemcitabine‐ or 5‐fluorouracil‐based chemotherapy and chemoradiation regimens. Patients and methods The Surveillance, Epidemiology and End Results ( SEER )‐Medicare database was used to identify patients with pancreatic cancer diagnosed from 1998 to 2005 who received curative surgery and adjuvant chemotherapy with either 5‐fluorouracil or gemcitabine. These groups were subdivided by treatment with radiotherapy. Patients were followed until death, study end‐point or a maximum of 5 years after diagnosis. Results Three hundred and fifty‐nine patients received 5‐fluorouracil and 346 received gemcitabine. Compared with chemoradiation with 5‐fluorouracil, outcomes for patients who received chemoradiation with gemcitabine did not differ. Patients who received gemcitabine without radiation had increased hazards (poorly differentiated tumours: HR = 1.50, p = 0.01; moderately differentiated tumours, HR = 1.28, p = 0.11). However, outcomes of patients who received 5‐fluorouracil without radiation varied with tumour grade. In moderately differentiated tumours, patients had better outcomes with 5‐fluorouracil when compared with chemoradiation with 5‐fluorouracil ( HR = 0.42, p = 0.02). In poorly differentiated tumours, the opposite was true ( HR 2.10, p = 0.09). Conclusion Patients with low‐grade resected pancreatic cancer may have better outcomes with 5‐fluorouracil‐based chemotherapy without radiation when compared with 5‐fluorouracil with radiation.