[Efficacy of gemcitabine combined oxaliplatin on advanced pancreatic cancer]

Abstract

Background & objective: Gemcitabine (GEM) is efficient in treating advanced pancreatic cancer. Preliminary clinical studies showed that the efficacy of gemcitabine combined oxaliplatin (GEMOX regimen) is better than that of gemcitabine alone. But in China, the use of GEMOX regimen for advance pancreatic cancer has seldom been reported. This study was to analyze the efficacy of GEMOX regimen on advanced pancreatic cancer, and observe the adverse events.

Methods: Clinical data of 32 chemonaive patients with stage III-IV pancreatic cancer, treated with GEMOX regimen [intravenous injection of gemcitabine (1 000 mg/m(2)) at Day 1 and Day 8, and intravenous injection of oxaliplatin (85-130 mg/m(2)) at Day 1; repeated every 21 days] at Cancer Center of Sun Yat-sen University from Feb. 2001 to Jun. 2006, were reviewed.

Results: Of the 32 patients, 8 achieved partial remission (PR), 8 had stable disease (SD), and 12 had progressive disease (PD)û the objective responses were not assessable (NA) in 4 patients. The response rate was 25.0%, and the clinical benefit response (CBR) rate was 46.9% (15 patients). The progression-free survival (PFS) was 4.7 months; the median overall survival was 8.6 months; the 1-year survival rate was 32.6%. The total occurrence rate of myelosuppression was 70.9%û the occurrence rate of grade III-IV myelosuppression was 32.3%: 12.9% for anemia, 19.4% for neutropenia, and 22.6% for thrombocytopenia. The occurrence rate of gastrointestinal adverse events was 56.2%û only 2 patients had grade III vomiting. Liver function damage (grade I-II) occurred in 8 (25.0%) patients; peripheral neurotoxicity (grade I) occurred in 14 (43.8%) patients. No chemotherapy-related death occurred.

Conclusions: GEMOX is an effective regimen for pancreatic carcinoma with good clinical tolerance. The main adverse event is myelosuppression.