Palliation with Previously Gemcitabine in Patients with Advanced Pancreatic Cancer Treated with the Placement of a Covered Metal Biliary Stent

Authors D. Xinopoulos, D. Dimitroulopoulos, A. Fotopoulou, D. Korkolis, K. Tsamakidis, D. Kypreos, S. Basioukas, S. Patsavela, A. Loukou, E. Paraskevas.


Background/Aim: To evaluate the efficacy of gemcitabine as palliation in patients with advanced pancreatic cancer (PC) previously treated with the placement of a covered metal biliary stent, taking into account survival and quality of life (QoL). Methods: Forty-nine patients with unresectable PC, and obstructive jaundice previously treated with the placement of a covered metal endoprosthesis, were randomized to receive gemcitabine (Group A: 9M,7F) or to followed without any anticancer intervention (Group B:18M,15F). Gemcitabine was administered weekly as an intravenous 30 min infusion of 1000 mg/m2 for 3 consecutive weeks followed by a 1-week rest in each cycle (28 days). QoL was evaluated with the QLQ-C30 questionnaire. Results:229 gemcitabine doses were administered [median 14.3 doses per patient (range 7-22)]. No statistically significant differences were observed regarding the survival (Group A:median 21 weeks, range 13-33, Group B: median 22 weeks, range 13-29, p=0.809). According to the average QLQ-C30 score for each patient, Group B presented statistically significant higher values (p=0.0001). Leucocytopenia, neutropenia, thrombocytopenia and anemia were the most common side effects in group A (81.25%, 68.75%, 56.25%, 31.25% respectively). Conclusion: Gemcitabine didn't show to improve survival and QoL in patients with advanced PC previously treated with a covered metallic endoprosthesis due to obstructive jaundice.
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