General Features of Pancreatic Cancer Patients and Survival Results

Yıl 2007, Cilt: 40 Sayı: 1, 14 - 18, 01.04.2007

Vahide Işıl Uğur Nadi Özdamar Şakire Pınar Kara Bülent Küçükplakçı Yeşim Elgin Cem Mısırlıoğlu Aytül Özgen Ergun Sanrı Tijen Yörükoğlu Taciser Demirkasımoğlu

Öz

Ankara Onkoloji Hastanesi Radyasyon Onkolojisi Kliniğine 1 Ocak 2000-31 Aralık 2005 tarihleri arasında başvuran 43 pankreas kanserli hasta retrospektif olarak değerlendirildi. Hastalar; genel özellikleri ve sağkalım sonuçlan açısından incelendi. Hastaların median yaşı 56 (min 38-maks 78 ), erkek/kadın oranı 3.3/1 olarak bulundu. En sık rastlanan tümör histopatolojisi adenokarsinom idi. Kliniğimize en çok T3 ve T4 hastalar başvurmuştu. Tümör en çok pankreas başında lokalize idi. Kırk üç hastanın 21'i öpere, 22'si inopere idi. inopere olanlardan 9'u paiyatif, 9'u küratif amaçla ışınlanmıştı. Tüm grupta 1, 2, 3 yıllık sağkalımlar sırasıyla %56, %34, %20 ve median sağkalım 14 ay olarak bulundu. Pankreas kanserinin tedavisinde yeni tedavi yaklaşımlarına gerek olduğu sonucuna ulaşıldı.

Anahtar Kelimeler

Pankreas kanseri, radyoterapi.

Pankreas Kanserli Hastalarımızın Genel Özellikleri ve Sağkalım Sonuçları

Öz

Fourty-three patients with pancreatic cancer treated at Radiation Oncology Department of Ankara Oncology Hospital between January 2000-December 2005 were revieved retrospectively. Median age of the patients were 56 (betvveen 38 and 78). Male/female ratio was 3.3/1. Adenocarcinoma was the most common histology. Most ofthem were T3 or T4 tumors. Head of the pancreas was the most common site. Twenty-one patients were operated, 22 patients were inoperable. Among inoperabie patients 9 of them were irradiated for curative purpose, 9 were irradiated for paliation. Overall 1, 2, 3 years survival rates were 56%, 34%, 20% respectively and the median survival time was 14 months. İn conciusion, pancreatic cancer has a poor prognosis and there is a need for new treatment modalities.

Anahtar Kelimeler

Pancreatic cancer, radiotherapy.

Kaynakça

• Silverman DT, Dunn JA, Hoover RN, et al.Cigarette smok- ing and pancreas cancer.a case-control study based on direct interviews. J Natl Cancer Inst 1994;86:1510-6.
• Warshaw AL, Fernandez-del Castillo C. Pancreatic carcino- ma. N Engl J Med 1992;326:455-65.
• Calvo FA, Viera JC, Gunderson LL, VVİllett CG. Cancer of the Pancreas. İn: Perez CA, Brady LW (eds). Principles and Practice of Radiation Oncology. 4th ed. Philadelphia: JB Lippincott, 2004:1574-88.
• Jemal A, ThomasA, Murray T, et al. Cancer statistics, 2002. CA Cancer J Clin 2002;52:23-47.
• Sindelar WF, Kinsella TJ, Mayer RJ. Cancer of the Pancreas. İn: De Vita VT, Hellman S, Rosenberg SA (eds). Cancer Principles and Practice of Oncology. 3rd ed. Philadelphia: JB Lippincott-Raven, 1997:691-739.
• Kanematsu M, Hoshi H, Yamada T, et al. Small hepatic nod- ules in cirrhosis: ultrasonographic, CT, and MRİmaging find- ings. Abdomin Imaging 1999;24:47-55.
• Hovvard JM, Jordan GL. Cancer of the pancreas. Curr Probl Cancer 1977;2:1-52.
• Niederhuber JE, Brennan MF, Menck HR. The National Cancer Data Base Report on pancreatic cancer. Cancer 1995;76:1671-7.
• Sohn TA, Yeo CJ, Cameron JL, et al. Resected adenocarci- noma of the pancreas -616 patients: Results, outcomes, and prognostic indicators. J Gastrointest Surg 2000;4:567- 79.
• Lillemoe KD. Current management of pancreatic carcinoma. Ann Surg 1995;221:133-48.
• Kalser MH, Ellenberg SS. Pancreatic cancer. Adjuvant com- bined radiation and chemotherapy following curative resec­ tion. Arch Surg 1985;120:899-903.
• Gastrointestinal Tumor Study Group. Comparative thera- peutic trial of radiation with or without chemotherapy in pan­ creatic carcinoma. Int J Radiat Oncol Biol Phys 1979;5:1643-7.
• Foo ML, Gunderson LL, Nagorney DM, et al. Paterns offail- ure in grossly resected pancreatic ductal adenocarcinoma treated with adjuvant irradiation +/- 5 fluorourasil. Int J Radiat Oncol Biol Phys 1993;26:483-9. 14. Yeo CJ, Abrams RA, Grochow LB, et al. Pancreaticoduodenectomy for pancreatic adenocarcinoma: Postoperative adjuvant chemoradiation improves survival. A prospective, single-institution experience. Ann Surg 1997;225:621-36.
• Bosset JF, Pavy JJ, Gillet M, et al. Conventional externai irradiation alone as adjuvant treatment in resectable pan­ creatic cancer: Results of a prospective study. Radiother Oncol 1992;24:191-4.
• Gastrointestinal Tumor Study Group. Radiation therapy combined with Adriamycin or 5-fluorourasil for the treatment of locally unresectabte pancreatic carcinoma. Cancer 1985;56:2563-8.
• Griffin JF, Smalley SR, Jewell W, et al. Patterns of failure after curative resection of pancreatic carcinoma. Cancer 1990;66:56-61.
• Willet CG, Lewandrowski K, Warshaw AL, et al. Resection margins in carcinoma of the head o f the pancreas. Implications for radiation therapy. Ann Surg 1993; 217:144-8.