Gemcitabine/5-FU/Leucovorin for the treatment of pancreatic carcinoma

The eflicacy and toxicity of a chemotherapy protocol consisting of Gemcitabine, 5-FU and Leucovorin in patients with different stages of pancreatic cancer was evaluated.Methods: Fifty-one chemo-naive patients with different stages of pancreatic cancer were treated with a chemotherapy protocol consisting of Gemcitabine 1000 mg/m2 on the first day, 5-FU 450 mg/m2 and Leucovorin 100 mg/m2 on days 1-3. The treatment was repeated every 2 weeks. Fourteen of our patients (male:female 9:5) received this protocol as their adjuvant chemotherapy after surgical treatment. Thirty-seven other patients with advanced pancreatic cancer (male:female 27:10) (67.6% stage IVb) were enrolIed.Results: With a mean time folIow-up of 25 months in the adjuvant group, aII the patients were alive and disease free. For the others, in an intention-to-treat analysis, seven (18.9%) partial responses were objectively achieved (95%CI: 8.33 to 29). fourteen (37.8%) patients had stable disease and 16 (43.2%) experienced progressive disease. The median response time was 3 months (ranged 1.5- 7.0). OveralI mean survival time was 6.5 months (ranged1.0-15.5). The response to chemotherapy revealed no significant difference in two genders (P=0.971). No cases of grade III/IV toxicities were seen in any of our patients.Conclusion: The combination of Gemcitabine with 5-FU and Leucovorin is an active and welI-tolerated regimen in patients with alI stages of pancreatic cancer, meriting further evaluation in prospective randomized studies. This combination may be considered a valuable altemative to Gemcitabine alone