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

Details

Serval ID
serval:BIB_DB37A850BC28
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Chemotherapy in patients with advanced pancreatic cancer: too close to death?
Journal
Supportive Care in Cancer
Author(s)
Frigeri M., De Dosso S., Castillo-Fernandez O., Feuerlein K., Neuenschwander H., Saletti P.
ISSN
1433-7339 (Electronic)
ISSN-L
0941-4355
Publication state
Published
Issued date
2013
Volume
21
Number
1
Pages
157-163
Language
english
Notes
Publication types: Journal Article
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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Create date
21/01/2013 16:20
Last modification date
20/08/2019 16:00
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