Efficacy and Toxicity of Palliative Chemotherapy in Elderly Patients With Advanced Pancreatic Cancer

Pancreas. 2024 Mar 1;53(3):e268-e273. doi: 10.1097/MPA.0000000000002299. Epub 2024 Feb 1.

Abstract

Objectives: We aimed to compare the efficacy and toxicity of palliative chemotherapy in elderly patients with pancreatic ductal adenocarcinoma (PDAC) with those in younger patients.

Methods: A total of 60 patients with locally advanced or metastatic PDAC who received FOLFIRINOX or nab-paclitaxel plus gemcitabine at our institution from January 2014 to December 2021 were analyzed. Patients 70 years or older were classified into an elderly group.

Results: The elderly group included 16 patients (26.7%). In the elderly group, nab-paclitaxel plus gemcitabine was used more than FOLFIRINOX compared with the young group (75.0% and 25.0% vs 34.1% and 64.9%, respectively; P = 0.008). The overall survival was not significantly different between the 2 groups (15.6 vs 13.4 months, P = 0.259). However, the elderly group showed better progression-free survival (11.4 vs 7.4 months, P = 0.034). The incidence of adverse events including neutropenia (75.0% vs 81.8%, P = 0.716), thrombocytopenia (25.0% vs 31.3%, P = 0.743), and anemia (50.0% vs 43.2%, P = 0.771) was not different between the 2 groups. Peripheral neuropathy was more common in the elderly group (18.3% vs 2.3%, P = 0.054), though not statistically significant.

Conclusion: The efficacy and toxicity of chemotherapy in elderly patients with advanced PDAC were comparable with those in younger patients.

MeSH terms

  • Aged
  • Albumins / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols* / adverse effects
  • Deoxycytidine / adverse effects
  • Fluorouracil / adverse effects
  • Gemcitabine* / adverse effects
  • Humans
  • Leucovorin / adverse effects
  • Paclitaxel / adverse effects
  • Pancreatic Neoplasms* / drug therapy
  • Pancreatic Neoplasms* / pathology
  • Treatment Outcome

Substances

  • Albumins
  • Deoxycytidine
  • Fluorouracil
  • Gemcitabine
  • Leucovorin
  • Paclitaxel