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Erschienen in: Supportive Care in Cancer 1/2013

01.01.2013 | Original Article

Chemotherapy in patients with advanced pancreatic cancer: too close to death?

verfasst von: M. Frigeri, S. De Dosso, O. Castillo-Fernandez, K. Feuerlein, H. Neuenschwander, P. Saletti

Erschienen in: Supportive Care in Cancer | Ausgabe 1/2013

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Abstract

Purpose

We evaluated the attitude in using chemotherapy near the end of life in advanced pancreatic adenocarcinoma (PAC). Clinical and laboratory parameters recorded at last chemotherapy administration were analyzed, in order to identify risk factors for imminent death.

Methods

Retrospective analysis of patients who underwent at least one line of palliative chemotherapy was made. Data concerning chemotherapy (regimens, lines, and date of last administration) were collected. Clinical and laboratory factors recorded at last chemotherapy administration were: performance status, presence of ascites, hemoglobin, white blood cell (WBC), platelets, total bilirubin, albumin, LDH, C-reactive protein (C-rp), and Ca 19.9.

Results

We analyzed 231 patients: males/females, 53/47 %; metastatic/locally advanced disease, 80/20 %; and median age, 66 years (range 32–85). All patients died due to disease progression. Median overall survival was 6.1 months (95 % CI 5.1–7.2). At the last chemotherapy delivery, performance status was 0–1 in 37 % and 2 in 63 %. Fifty-nine percent of patients received one chemotherapy line, while 32, 8, and 1 % had second-, third-, and fourth line, respectively. The interval between last chemotherapy administration and death was <4 weeks in 24 %, ≥4–12 in 47 %, and >12 in 29 %. Median survival from last chemotherapy to death was 7.5 weeks (95 % CI 6.7–8.4). In a univariate analysis, ascites, elevated WBC, bilirubin, LDH, C-rp and Ca 19.9, and reduced albumin were found to predict shorter survival; however, none of them remained significant in a multivariate analysis.

Conclusions

A significant proportion of patients with advanced PAC received chemotherapy within the last month of life. The clinical and laboratory parameters recorded at last chemotherapy delivery did not predict shorter survival.
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Metadaten
Titel
Chemotherapy in patients with advanced pancreatic cancer: too close to death?
verfasst von
M. Frigeri
S. De Dosso
O. Castillo-Fernandez
K. Feuerlein
H. Neuenschwander
P. Saletti
Publikationsdatum
01.01.2013
Verlag
Springer-Verlag
Erschienen in
Supportive Care in Cancer / Ausgabe 1/2013
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-012-1505-9

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