Full-dose gemcitabine is a more effective chemotherapeutic agent than 5-fluorouracil for concurrent chemoradiotherapy as first-line treatment in locally advanced pancreatic cancer

Huapyong Kang, Jee Suk Chang, Tak Geun Oh, Moon Jae Chung, Jeong Youp Park, Seung Woo Park, Jinsil Seong, Si Young Song, Jae Bok Chung, Seungmin Bang

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: To compare the efficacy of full-dose gemcitabine-based concurrent chemoradiotherapy (FG-CCRT) and conventional 5-fluorouracil CCRT (5FU-CCRT) for locally advanced pancreatic cancer (LAPC). Methods: 109 LAPC cases treated with FG-CCRT (n = 89) or 5FU-CCRT (n = 20) were reviewed retrospectively. The FG-CCRT group was composed of a full-dose gemcitabine monotherapy (1,000 mg/m2) arm and a combination therapy with cisplatin (70 mg/m2) arm. The 5FU-CCRT group used a radiosensitizing dose of 5-FU (500 mg/m2) plus leucovorin (20 mg/m2). Concurrent radiotherapy was targeted at the tumor with a 5-mm margin without lymph node irradiation. Results: Objective response rate (ORR) and disease control rate (DCR) was significantly higher in the FG-CCRT group (ORR: 32.6 vs. 5%, p = 0.013; DCR: 79.8 vs. 50.0%, p = 0.006). FG-CCRT showed remarkable superiority to 5FU-CCRT for suppressing distant metastasis (18.0 vs. 45.0%, p = 0.017). Neutropenia (34.8 vs. 10%, p = 0.032) and thrombocytopenia (21.3 vs. 0.0%, p = 0.021) were more frequent in the FG-CCRT group as originally expected. When dividing the FG-CCRT group to gemcitabine monotherapy (GEM) and gemcitabine plus cisplatin, toxicities of the GEM subgroup were not different than those of the 5FU-CCRT group. Conclusion: FG-CCRT, especially full-dose gemcitabine monotherapy-based CCRT was more effective for the initial control of LAPC than 5FU-CCRT, and also relatively safe.

Original languageEnglish
Pages (from-to)191-199
Number of pages9
JournalChemotherapy
Volume60
Issue number3
DOIs
Publication statusPublished - 2014 Apr 24

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pharmacology
  • Drug Discovery
  • Pharmacology (medical)
  • Infectious Diseases

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