Turkish Journal of Geriatrics 2019 , Vol 22, Issue 4
COMPARISON OF THREE FIRST-LINE TREATMENTS IN ADVANCED PANCREATIC CANCER PATIENTS OLDER THAN 65 YEARS OF AGE: SINGLE-CENTRE EXPERIENCE
Derya KIVRAK SALİM1, MUSTAFA YILDIZ1
1University of Health Sciences, Antalya Education and Research Hospital. Medical Oncology Department, Muratpaşa/Antalya, Turkey DOI : 10.31086/tjgeri.2020.116 Introduction: Elderly advanced pancreatic cancer patients are frequently undertreated due to comorbidities, age, lack of evidence-based clinical practice guidelines for senior patients and patient"s or physician"s preference. An optimal, less toxic and most efficacious first-line chemotherapy regimen should be elucidated. The present study aimed to compare the efficacy and toxicity profiles of three first-line treatment regimens and describe prognostic factors in elderly pancreatic cancer patients.

Materials and Method: Patients of an age >65 years with histologically confirmed metastatic pancreatic adenocarcinoma not amenable to curative surgical resection were included in the study. Efficacy and toxicity profiles of FOLFIRINOX (Group A, 16 patients), cisplatin-gemcitabine combination therapies (Group B, 16 patients) and gemcitabine monotherapy (Group C, 15 patients) in elderly patients with advanced pancreatic cancer were evaluated retrospectively.

Results: There was no difference between the groups in terms of disease control rates, overall survival, and progression-free survival. Age, primary tumour resection, tumour grade and use of second-line chemotherapy were not found to be independently prognostic on overall survival (OS). Younger age <70 (p=0.028) and cisplatin-gemcitabine chemotherapy positively prognostic on OS (p=0.011) whereas liver involvement was negatively prognostic on OS (p=0.046). The toxicities of the groups were not different from each other but the hospitalization was statistically higher in FOLFIRINOX group.

Conclusion: The study revealed that there are no differences in disease control rates and adverse events of three regimens but showed increased overall survival with cisplatin?gemcitabine combination in elderly patients with pancreatic cancer. Keywords : Pancreatic cancer; Therapeutics; Geriatrics