Lokal İleri Rezektabl Olmayan Pankreas Kanserinde Kemoradyoterapi ve Kemoterapinin Sağkalım ve Toksisite Üzerine Etkileri

Öz

Lokal ileri rezeke edilemeyen pankreas kanseri için optimal tedavi yaklaşımı halen tartışmalıdır. Bu çalışmada lokal ileri rezeke edilemeyen pankreas kanserli hastalarda kemoterapi ve kemoradyoterapi tedavilerinin sağkalım ve toksisite üzerine etkilerinin karşılaştırılması amaçlandı. Toplam 59 hasta retrospektif olarak değerlendirildi. Hastaların genel sağkalım (OS), progresyonsuz sağkalım (PFS) ve tedaviye bağlı toksisiteleri incelendi. Yirmi beş hastaya kemoterapi sonrası eş zamanlı gemsitabin ile radyoterapi uygulanırken, 34 hasta yalnız kemoterapi aldı. Sağkalım analizleri Kaplan-Meier yöntemi ile yapıldı ve gruplar log-rank testi ile karşılaştırıldı. Kemoradyoterapi grubunda sağkalım anlamlı olarak daha yüksek bulundu. Ortalama OS ve PFS sırasıyla 19,27±4,14 ay ve 17,09±4,06 ay iken, kemoterapi grubunda 12,39±2,43 ay ve 7,60±0,93 ay olarak saptandı (p=0,040 ve p=0,006). Toksisite açısından değerlendirildiğinde, kemoradyoterapi grubunda %20,8 oranında grade 3–4 gastrointestinal mukozit ve %4–12,5 oranında hematolojik toksisite gözlenirken, kemoterapi grubunda hematolojik toksisite %11–14 ve gastrointestinal toksisite %17,6 olarak bulundu. Gruplar arasında toksisite açısından anlamlı fark saptanmadı. Sonuç olarak çalışmamızın bulguları, kemoradyoterapinin lokal ileri rezeke edilemeyen pankreas kanserinde sağkalım üzerine olumlu katkı sağlayabileceğini düşündürmektedir.

Anahtar Kelimeler

• lokal ileri pankreas kanseri
• kemoterapi
• kemoradyoterapi
• sağkalım
• toksisite

Destekleyen Kurum

YOKTUR

Etik Beyan

Uludağ Üniversitesi Tıp Fakültesi Araştırma Etik Kurulu’ndan 21.01.2011 tarihli ve 2011-3/42 sayılı etik kurul onayı alınmıştır.

Teşekkür

Tez Öğrencisi Olduğum ve yazım sürecinde her türlü yardımlarını benden esirgemeyen Sayın Prof.Dr.Ender Kurt' a Teşekkür Ederim.

Effects of Chemotherapy and Chemoradiotherapy on Survival and Toxicity in Locally Advanced Unresectable Pancreatic Cancer

Öz

The optimal treatment for locally advanced, unresectable pancreatic cancer remains controversial. This study aimed to compare the effects of chemotherapy and chemoradiotherapy on survival and toxicity in patients with locally advanced, unresectable pancreatic cancer. A total of 59 patients were retrospectively analyzed. Overall survival (OS), progression-free survival (PFS), and treatment-related toxicities were evaluated. Twenty-five patients received chemotherapy followed by concurrent radiotherapy with gemcitabine, while 34 patients received chemotherapy alone. Survival differences were analyzed using the Kaplan–Meier method and compared with the log-rank test. Survival was significantly improved in the chemoradiotherapy group. Median OS and PFS were 19.27 and 17.09 months, respectively, compared with 12.39 and 7.60 months in the chemotherapy group (p=0.040 and p=0.006). Grade 3–4 gastrointestinal mucositis occurred in 20.8% of patients receiving chemoradiotherapy, while grade 3–4 hematological toxicity was observed in 4–12.5%. In the chemotherapy group, hematological toxicity was 11–14% and gastrointestinal toxicity was 17.6%. No significant difference in toxicity was found between the groups. In conclusion, the findings of our study suggest that chemoradiotherapy may contribute positively to survival in patients with locally advanced unresectable pancreatic cancer.

Anahtar Kelimeler

• locally advanced pancreatic cancer
• chemotherapy
• chemoradiotherapy
• survival
• toxicity

Destekleyen Kurum

ABSENT

Etik Beyan

Ethics Committee approval: January 01, 2011; No. 2011- 3/42

Teşekkür

I would like to express my sincere gratitude to Prof. Dr. Ender Kurt for his invaluable guidance and support throughout my thesis study and the writing process.

Kaynakça

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