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Changes in chemotherapy for pancreatic cancer
1Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi
|June 28, 2000
Summary
Systemic chemotherapy offers limited benefit for pancreatic cancer patients, with gemcitabine showing some efficacy in symptom relief. Future research should explore gemcitabine-based combinations and combined modality treatments.
Area of Science:
- Oncology
- Medical Oncology
Background:
- Pancreatic cancer has a poor prognosis, with surgery only an option for a small percentage of patients.
- Palliative chemotherapy provides marginal benefits for the majority of patients with advanced pancreatic cancer.
Purpose of the Study:
- To review current systemic chemotherapy regimens for pancreatic cancer.
- To evaluate the efficacy of various chemotherapy agents and combinations.
Main Methods:
- Comprehensive literature search of Medline and non-Medline databases from 1966 to 1999.
- Inclusion of phase II, randomized controlled, and preclinical studies using keywords like 'pancreatic carcinoma' and 'chemotherapy'.
Main Results:
- Combination chemotherapy regimens, including fluorouracil with folinic acid or interferon, have not significantly improved tumor response or survival.
- Gemcitabine demonstrates superior efficacy over fluorouracil in pain relief and reducing disease-related symptoms.
- Novel approaches like immunotherapy and monoclonal antibodies have shown limited clinical success.
Conclusions:
- Systemic chemotherapy is largely ineffective in prolonging survival for pancreatic cancer patients.
- Future research should prioritize gemcitabine-based combination chemotherapy and combined modality treatments with radiotherapy.