AIM： To investigate second-line chemotherapy in gemcitabine-pretreated patients with advanced or metastat- ic pancreatic cancer [（frequency, response, outcome, course of carbohydrate antigen 19-9 （CA 19-9）].METHOD...AIM： To investigate second-line chemotherapy in gemcitabine-pretreated patients with advanced or metastat- ic pancreatic cancer [（frequency, response, outcome, course of carbohydrate antigen 19-9 （CA 19-9）].METHODS： This retrospective study included all patients with advanced or metastatic pancreatic cancer （adenocarcinoma or carcinoma） treated with secondline chemotherapy in our center between 2000 and 2008. All patients received first-line chemotherapy with gemcitabine, and prior surgery or radiotherapy was permitted. We analyzed each chemotherapy protocol for second-line treatment, the number of cycles and the type of combination used. The primary endpoint was overall survival. Secondary endpoints included progression-free survival, response rate, grade 3-4 toxicity, dosage modifications and CA 19-9 course.a second-line therapy among 206 patients who had initially received first-line treatment with a gemcitabi- ne-based regimen. Median number of cycles was 4 （range： 1-12） and the median duration of treatment was 2.6 mo （range： 0.3-7.4）. The overall disease control rate was 40.0%. The median overall survival and progression-free survival from the start of second-line therapy were 5.8 （95% CI： 4.1-6.6） and 3.4 mo （95% CI： 2.4-4.2）, respectively. Toxicity was generally acceptable. Median overall survival of patients with a CA 19-9 level declining by more than 20% was 10.3 mo （95% CI： 4.5-11.6） vs 5.2 mo （95% CI： 4.0-6.4） for others （P = 0.008）.CONCLUSION： A large proportion of patients could benefit from second-line therapy, and CA 19-9 allows efficient treatment monitoring both in first and secondline chemotherapy.展开更多
文摘AIM： To investigate second-line chemotherapy in gemcitabine-pretreated patients with advanced or metastat- ic pancreatic cancer [（frequency, response, outcome, course of carbohydrate antigen 19-9 （CA 19-9）].METHODS： This retrospective study included all patients with advanced or metastatic pancreatic cancer （adenocarcinoma or carcinoma） treated with secondline chemotherapy in our center between 2000 and 2008. All patients received first-line chemotherapy with gemcitabine, and prior surgery or radiotherapy was permitted. We analyzed each chemotherapy protocol for second-line treatment, the number of cycles and the type of combination used. The primary endpoint was overall survival. Secondary endpoints included progression-free survival, response rate, grade 3-4 toxicity, dosage modifications and CA 19-9 course.a second-line therapy among 206 patients who had initially received first-line treatment with a gemcitabi- ne-based regimen. Median number of cycles was 4 （range： 1-12） and the median duration of treatment was 2.6 mo （range： 0.3-7.4）. The overall disease control rate was 40.0%. The median overall survival and progression-free survival from the start of second-line therapy were 5.8 （95% CI： 4.1-6.6） and 3.4 mo （95% CI： 2.4-4.2）, respectively. Toxicity was generally acceptable. Median overall survival of patients with a CA 19-9 level declining by more than 20% was 10.3 mo （95% CI： 4.5-11.6） vs 5.2 mo （95% CI： 4.0-6.4） for others （P = 0.008）.CONCLUSION： A large proportion of patients could benefit from second-line therapy, and CA 19-9 allows efficient treatment monitoring both in first and secondline chemotherapy.
