Recurrent Pancreatic Cancer
Chemotherapy occasionally produces objective antitumor response, but the low
percentage of significant responses and lack of survival advantage warrant use
of therapies under evaluation.[1]
Standard treatment options:
- Chemotherapy (fluorouracil [2] or gemcitabine [3-5] ).
- Palliative surgical bypass procedures, endoscopic or radiologically placed
stents.[6,7]
- Palliative radiation procedures.
- Pain relief by celiac axis nerve or intrapleural block (percutaneous).[8]
- Other palliative medical care alone.
Treatment options under clinical evaluation:
Clinical trials evaluating pharmacologic modulation of fluorinated pyrimidines,
new anticancer agents, or biologicals (phase I and II). Information about ongoing clinical
trials is available from the NCI Cancer.gov Web site.
References
- Evans DB, Abbruzzese JL, Willett CG: Cancer of the pancreas. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds.: Cancer: Principles and Practice of Oncology. 6th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2001, pp 1126-1161.
- Cullinan SA, Moertel CG, Fleming TR, et al.: A comparison of three chemotherapeutic regimens in the treatment of advanced pancreatic and gastric carcinoma. Fluorouracil vs fluorouracil and doxorubicin vs fluorouracil, doxorubicin, and mitomycin. JAMA 253 (14): 2061-7, 1985.
[PUBMED Abstract]
- Rothenberg ML, Moore MJ, Cripps MC, et al.: A phase II trial of gemcitabine in patients with 5-FU-refractory pancreas cancer. Ann Oncol 7 (4): 347-53, 1996.
[PUBMED Abstract]
- Burris HA 3rd, Moore MJ, Andersen J, et al.: Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol 15 (6): 2403-13, 1997.
[PUBMED Abstract]
- Storniolo AM, Enas NH, Brown CA, et al.: An investigational new drug treatment program for patients with gemcitabine: results for over 3000 patients with pancreatic carcinoma. Cancer 85 (6): 1261-8, 1999.
[PUBMED Abstract]
- Sohn TA, Lillemoe KD, Cameron JL, et al.: Surgical palliation of unresectable periampullary adenocarcinoma in the 1990s. J Am Coll Surg 188 (6): 658-66; discussion 666-9, 1999.
[PUBMED Abstract]
- Baron TH: Expandable metal stents for the treatment of cancerous obstruction of the gastrointestinal tract. N Engl J Med 344 (22): 1681-7, 2001.
[PUBMED Abstract]
- Polati E, Finco G, Gottin L, et al.: Prospective randomized double-blind trial of neurolytic coeliac plexus block in patients with pancreatic cancer. Br J Surg 85 (2): 199-201, 1998.
[PUBMED Abstract]
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