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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2002, Number 4

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An Med Asoc Med Hosp ABC 2002; 47 (4)

Gemcitabin in pancreatic cancer

Gerson R, Serrano OA, Villalobos xvarri Y

Language: Spanish
References: 15
Page: 211-216
PDF size: 50.24 Kb.


ABSTRACT

Background: Median survival at 5 years with locally advanced or metastasic pancreatic carcinoma is 4 months and quality of life is strongly affected by symptoms as pain, nausea and weakness. Objective: To analyze the side effects, therapeutic results and the survival in patients with advanced pancreatic carcinoma treated with gemcitabine. Patients with confirmed pancreatic carcinoma, in adult age, no race nor gender distinction treated with gemcitabine 1,250 mg/m2, d1, 8 and 15. Patients with serum creatinine > 1.5 mg/dL, total bilirrubine › 2 mg/L white blood cells count ‹ 3,500 cel/mm3, hemoglobin ‹ 9 g/L and platelets ‹ 100,000/mm3 were excluded. Age, gender, time of diagnosis, histological type, clinical stage, number and metastatic sites, Karnofsky’s scale, number of cycles, leucocyte, platelet and hemoglobin counts per application as well as associated symptoms were evaluated. Also, therapeutic response, side effects, duration of response and cause of death were registered. Results: 20 patients, mean age 60.8 ± 9.6 years. 16 (80%) with metastasis at diagnosis and 4 (20%) in stage III. 15 (75%) had hepatic involvement, 2 (10%) pulmonary and 2 in other sites. 275 applications were administered in 20 pts, 13.7 ± 10.8 doses/pt, range 3 to 49. 15 patients (75%) complainted of adverse symptomatology. Nausea in 8, 40%; epigastric pain 6, 30%; somnolence 4, 20%; constipation 3; 15%, dysuria; leg edema, 10% and dyspnea, dysgeusia, abdominal distension, digestive tract bleeding, mucositis and deep venous thrombosis in 1 patient, 5%. Leucopenia was observed in 69 of 275 applications, 25.1%; anemia in 99, 36% and thrombocytopenia in 50, 18.2%. Follow-up time 10.15 ± 8.9 mos, range 1 to 42. One patient, 7.14%, showed complete response, 6 (42.8%) partial, response rate 49.9%. Initial Karnofsky’s scale 79.5 ± 3.4, at intermediate 76.6 ± 8.7 and final 74 ± 9.1, p = 0.33. Mean duration of response 6.2 ± 3.6 mos, range 2 to 14. 13 pts, 65% died. Two patients lived for more than 12 months and 2 more than 24. Conclusions: Gemcitabine is an active agent againts pancreatic carcinoma with some prolonged responses. It produces important subjective benefit that reflects in quality of life. It is well tolerated, side effects are infrequent and of low grade.


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