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Gemcitabine as first-line chemotherapy in elderly patients with unresectable pancreatic carcinoma

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Gemcitabine (GEM) is the key drug for the chemotherapy of unresectable pancreatic cancer. However, the efficacy and safety of GEM has not been established in elderly patients. We retrospectively examined the prognosis of elderly pancreatic cancer patients treated with GEM.

Methods

Sixty-six patients with unresectable pancreatic cancer (pathologically identified) and no prior chemotherapy were divided into three groups. Group A: patients aged 70 years or more who received standard GEM (1000 mg/m2) on days 1, 8, and 15 and rest on day 21; Group B: patients less than 70 years old who received standard GEM therapy; and Group C: patients under best supportive care.

Results

Median survival times (MSTs) (days) were 311 in group A (p < 0.05 vs. group C), 292 in group B (p < 0.05 vs. group C), and 127 in group C. Among the patients who received GEM, 23% patients in group A and 16% patients in group B obtained partial responses. The response rates and MSTs were similar in groups A and B, as well as in more aged (≥75 years) patients. Bone marrow suppression was more frequently seen in elderly patients. Cox’s hazard model in patients aged 70 years or more revealed that GEM therapy reduced the hazard ratio for death (hazard ratio: 0.683, p = 0.041).

Conclusions

Chemotherapy with GEM appears to be effective and safe in elderly patients as well as in younger patients. Patients with unresectable pancreatic carcinoma should receive GEM therapy even if they are aged 70 or more, even if they are aged 75 or more.

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Abbreviations

GEM:

Gemcitabine

CR:

Complete response

PR:

Partial response

SD:

Stable disease

PD:

Progressive disease

MST:

Median survival time

BSC:

Best supportive care

RDI:

Relative dose intensity

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Acknowledgments

This study was supported by grants from the Japanese Ministry of Education, Science, and Culture, and by a Keio University Grant-in-Aid for Encouragement of Young Medical Scientists.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Yoshiyuki Yamagishi, Hajime Higuchi, Motoko Izumiya, Gen Sakai, Hideko Iizuka, Shoko Nakamura, Masayuki Adachi, Sigenari Hozawa, Hiromasa Takaishi & Toshifumi Hibi

Authors
  1. Yoshiyuki Yamagishi
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  2. Hajime Higuchi
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  3. Motoko Izumiya
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  4. Gen Sakai
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  5. Hideko Iizuka
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  6. Shoko Nakamura
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  7. Masayuki Adachi
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  8. Sigenari Hozawa
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  9. Hiromasa Takaishi
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  10. Toshifumi Hibi
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Corresponding authors

Correspondence to Hiromasa Takaishi or Toshifumi Hibi.

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Yamagishi, Y., Higuchi, H., Izumiya, M. et al. Gemcitabine as first-line chemotherapy in elderly patients with unresectable pancreatic carcinoma. J Gastroenterol 45, 1146–1154 (2010). https://doi.org/10.1007/s00535-010-0258-9

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  • DOI: https://doi.org/10.1007/s00535-010-0258-9

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