Objective: The aim of the study was to assess the benefit of treatment modalities on the survival in patients with advanced pancreatic cancer and clinical factors affecting treatment efficacy and survival.
Material and methods: One hundred eleven patients with advanced pancreatic cancer were analyzed retrospectively. Patients were grouped by treatment method, clinical stage, and Karnofsky Performance Index. Fifty-three patients were diagnosed with locally advanced disease and 58 with metastatic pancreatic cancer. Thirty-three patients at the time of diagnosis had Karnofsky Performance Index higher than 70, and in 78 patients it was 70 or lower. Fourteen patients were treated by concomitant chemoradiotherapy with gemcitabine or 5-fluorouracil, 25 - with gemcitabine only, and 72 patients underwent surgical palliation or observation alone.
Results: Patients treated with gemcitabine alone survived for 9.5 months, p<0.001. Overall median survival of patients treated with concomitant chemoradiation was 8.5 months. Comparison of survival results between groups of patients treated with gemcitabine alone and the patients who have received radiation therapy with 5-fluorouracil (median survival 6.4 months) or gemcitabine (median survival - 8.8 months) revealed no difference. Median survival after surgical palliation or observation was 1.9 months. Patients diagnosed with locally advanced pancreatic cancer and patients with Karnofsky Performance Index higher than 70 at diagnosis lived statistically longer than patients diagnosed with metastatic disease or Karnofsky Performance Index of 70 or lower.
Conclusions: Patients diagnosed with locally advanced pancreatic cancer, better performance status at diagnosis and treated with monochemotherapy with gemcitabine or combination of gemcitabine or 5-fluorouracil with radiation survived longer, than patients diagnosed with metastatic disease, patients of worse functional status and treated by palliative methods only.