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Survival and Quality of Life of Patients with Advanced Pancreatic Cancer
ED Hager, H Dziambor, D Hohmann, BioMed-Hospitals, Bad Bergzabern, Germany
Objective: Reproducible responses to single-agent or combination chemotherapy are <10% and the percentage of symptomatic relief by treatment with 5-FU or gemcitabine is 5% and 25%, respectively, with a MST of 4-6 months (1).
Chemotherapy plus irradiation increases survival time not appreciably (2-4 months), but is accompanies with heavy side effects.
In a retrospective study, a prolongation of median surval time (MST) of patients (pts) with pancreatice cancer of 12 months was observed by a multimodal treatment without chemotherapy. (2,3)
Therefore in a prospective trial the results of the retrospective study should be tested and the quality of life (QOL) estimated.
Methods: In a prospective study 46 pts with far advanced, nonresectable, recurrent or metastasized adenocarinoma of the pancreas were treated.
Median age of study entry was 62 years (range 38-82). In the median Karnofsky Index 50% (range 30-90). Six patients suffered from jaundice and 10 showed ascites at study entry.
The multimodal non-toxic treatment consisted of high-dose enzyme therapy, hormonal therapies(Tamoxifen, GnRH analogues), differentiating agents, unspecific immunotherapies (thymus peptides, mistletoe-lectins), and regional deep hyperthermia. (13.56 MHz, Therathem, Italy).
The QOL was measured by the EORTC QLQ-C30; analysis has been performedfor 3 treatment cycles.
Summary and Conclusion:
1. MST of pts with far advanced carcinoma of the pancreas was prolonged compared to CTx alone if treated with a multimodal non-toxic Tx.
2. 1-yr OSR of 41% and 5-year OSR of 9% was clinically significantly increased compared to 3-18% and <0.2% with chemotherapy.
3. Quality of Life and appetite was improved statistical significantly at each treatment cycle and pain reduced.
4. The treatment is safe and well-tolerated.
5. The prospective open-label study confirms results of a previous retrospective trial.
6. Symptom relief could be achieved after rechallenge following discontinuation of Tx.
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