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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    International journal of clinical oncology 4 (1999), S. 257-266 
    ISSN: 1437-7772
    Keywords: Key words Pancreatic cancer ; Radiotherapy ; Chemotherapy ; Chemoradiotherapy ; Gemcitabine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Although pancreatic cancer (PC) continues to be a formidable disease, numerous treatment strategies are evolving and it is hoped that these will result in improved patient survival. Only surgical resection offers the opportunity for cure, but the prognosis of resected patients remains unfavorable because of postoperative recurrence. Accordingly, to improve the survival of PC patients, it is essential to develop effective non-surgical treatments for this disease. Radiotherapy (RT) alone does not have a significant clinical impact in PC, but when combined with chemotherapy (CHT), it provides a survival benefit in both locally unresectable and adjuvant settings of PC. However, to establish optimal methods of combining RT with CHT, newer approaches, such as specialized RT techniques and new CHT agents, are actively being pursued. CHT for PC has only limited value in clinical practice, because of the lack of any agent with a truly high level of activity. The identification of more effective new agents is therefore a high priority, and the enrollment of PC patients with metastatic disease into well designed clinical trials is essential. The novel nucleoside analog, gemcitabine, appears to have the potential to produce better results than those achieved over the last 35 years with 5-fluorouracil (5-FU). Moreover, increased understanding of the biology of PC should facilitate the development of entirely novel treatment options. We must continue to actively search for more effective non-surgical treatments for PC.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1437-7772
    Keywords: Key words Pancreatic cancer ; National database ; Multidisciplinary treatment ; Survival
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. The Japanese Pancreas Society Registry Committee obtained data on 16 071 patients with pancrea-tic cancer diagnosed from 1981 to 1996. This is the largest multi-institutional retrospective study of the Japanese experience to describe the extent of disease and survival. Methods. Data were summarized according to age and sex and location of the disease. Survival analysis, using the Kaplan-Meier method, was performed according to surgical stage and therapeutic categories. Results. The male : female ratio was 1.6 : 1. The peak age was in the patients' sixties for both sexes. Forty-five per-cent of the primary tumors were located in the head of the pancreas. The survival of the patients depended on the histological diagnosis and surgical stage. The most com-mon histology, invasive ductal carcinoma, had the worst prognosis, and the 5-year survival of patients with stage I, II, III, IVa, and IVb disease was 66%, 55%, 21%, 11%, and 6% respectively. At the time of presentation, only 2.5% of the patients had stage I disease, while more than 70% had stage IV. Conclusions. Improvements in early detection strategies and more effective chemical or biological therapeutic agents, together with pancreatectomy, tested in well organized randomized prospective trials, will be the only way to cure this fatal disease.
    Type of Medium: Electronic Resource
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