Gemcitabine-based Concurrent Chemoradiotherapy Versus Chemotherapy Alone in Patients with Locally Advanced Pancreatic Cancer

Objective: To explore improved treatment by retrospectively comparing survival time of gemcitabine-basedconcurrent chemoradiotherapy (GemRT) versus chemotherapy (Gem) alone in patients with locally advancedpancreatic cancer (LAPC).
Methods: From January 2005 to June 2010, 56 patients with LAPC from Subei People’sHospital were treated either with Gem (n=21) or GemRT (n=35). Gem consisted of 4-6 cycles gemcitabine alone(1000 mg/m2 on Days 1, 8, 15, 28-day a cycle). GemRT consisted of 50.4Gy/28F radiotherapy with concurrent 2cycles of gemcitabine (1000 mg/m2 on days of radiation 1, 8, 15, 21-day a cycle). Radiation was delivered to thegross tumor volume plus 1-1.5 cm by use of a three-dimensional conformal technique. The follow-up time wascalculated from the time of diagnosis to the date of death or last contact. Kaplan-Meier methodology wes usedto evaluate survival.
Results: Patient characteristics were not significantly different between treatment groups.The disease control rate and the objective response rate of GemRT versus Gem was 97.1% vs 71.4%, 74.3%vs 38.1%. The overall survival (OS) was significantly better for GemRT compared to Gem (median 13 monthsversus 8 months; 51.4% versus 14.3% at 1 year, respectively).
Conclusion: Radiation therapy at 50.4Gy with2 concurrent cycles of gemcitabine results in favorable rates of OS. Concurrent chemoradiotherapy should bethe first choice for patients with LAPC.