The efficacy of gemcitabine alone versus gemcitabine plus cisplatin in the treatment of metastatic pancreatic cancer

INTRODUCTION: The purpose of this trial was to evaluate the efficacy of gemcitabine (G) alone versus gemcitabine plus cisplatin (GP) in the treatment of metastatic pancreatic cancer. METHODS: In ninety-nine patients with a histopathologically confirmed diagnosis of metastatic pancreatic cancer from April 2005 to December 2015, factors affecting progression-free (PFS) and overall survival (OS) (clinicopathological features, treatments, basal tumor markers, serum albumin, creatinine and bilirubin levels) were retrospectively evaluated.
METHODS: In ninety-nine patients with a histopathologically confirmed diagnosis of metastatic pancreatic cancer from April 2005 to December 2015, factors affecting progression-free (PFS) and overall survival (OS) (clinicopathological features, treatments, basal tumor markers, serum albumin, creatinine and bilirubin levels) were retrospectively evaluated.
RESULTS: Response evaluations were performed in 99 patients (74 patients for GP group, 25 patients for G group) who received three cycles and more chemotherapy (CT). When the groups were compared in terms of their demographic characteristics, the patients in the group receiving GP were younger with a better performance status and had less comorbid disease. About 41.4% of the patients received second line CT after progression (28.0% in the G group, 45.9% in the GP group). The median OS was 8.3 months in the GP group and 6.0 months in the G group (P=0.13). The median PFS was 5.1 months in the GP group and 3.9 months in the G group (P=0.01). In multivariate analysis, combination CT was associated with longer PFS (5.1 vs. 3.9 months). Patients with a good performance status (8.3 vs. 6.3 months), and those who received second-line CT (12.1 vs. 5.9 months ) were associated with longer OS.
DISCUSSION AND CONCLUSION: Compared with G, GP significantly improved PFS without any significant difference in OS. Patients with a good performance status and those receiving second-line CT had longer median OS.

Metastatik Pankreas Kanserinde Gemsitabin-Sisplatin Kombine Kemoterapisi Etkinliðinin Yalnýzca Gemsitabin Kemoterapisi ile Karþýlaþtýrýlmasý

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý metastatik pankreas kanserinin tedavisinde gemsitabin-sisplatin (GP) kombine kemoterapisine (KT) karþý gemsitabin (G) kemoterapisinin etkinliðini deðerlendirmektir.
YÖNTEM ve GEREÇLER: Nisan 2005 ile Kasým 2015 tarihleri arasýnda merkezimizde histopatolojik olarak adenokarsinom tanýsý almýþ metastatik pankreas kanserli hastalarda progresyonsuz saðkalýma (PS) ve genel saðkalýma (GS) etki eden faktörler (klinikopatolojik özellikler, tedaviler, bazal tümör markýrlarý, serum albümin, kreatinin ve bilirubin düzeyleri) retrospektif olarak deðerlendirildi.
BULGULAR: Üç kür ve üzerinde KT alan toplam 99 hastanýn (74 hasta GP, 25 hasta G) yanýt deðerlendirmesi yapýldý. Gruplar demografik özellikleri açýsýndan karþýlaþtýrýldýðýnda kombine KT alan hastalar daha genç, daha iyi ECOG performans skoruna ve daha az komorbid hastalýða sahipti. Hastalarýn %41.4’ü progresyondan sonra ikinci basamak KT almýþ olup, bu G grubunda %28.0, GP grubunda ise %45.9’du. GP ve G gruplarý arasýnda GS farký saptanmadý (sýrasýyla; 8.3 aya karþý 6.0 ay, P=0.13). Ortanca PS GP alan hastalarda G alan hastalara kýyasla daha uzundu (sýrasýyla; 5.1 ay ve 3.9 ay, P=0.01) ve bu fark çok deðiþkenli analizle de doðrulandý. ECOG performans skoru daha iyi (8.3 aya karþý 6.3 ay) ve ikinci basmak KT alan hastalar (12.1 aya karþý 5.9 ay ) daha uzun GS ile iliþkili saptandý.
TARTIÞMA ve SONUÇ: Gemsitabin-sisplatin tedavisi ile daha iyi PS elde edilirken GS farký istatiksel olarak anlamlý deðildi. Taný anýnda ECOG performans durumunu daha iyi ve ikinci basamak KT alabilen hastalar daha iyi genel sað kalýma sahiptir.