A201
Survival, tolerability of treatment and prognostic factors in elderly patients receiving chemotherapy for advanced pancreatic cancer: a retrospective analysis
Simon Lord, Emma Woodward, Peter Hall, Matthew Seymour
Leeds Institute of Oncology, Leeds, UK
Background
In the UK 85% of pancreatic cancer cases occur in patients over the age of 65 years most being incurable at presentation. Palliative chemotherapy can improve survival and quality of life but standard regimens have emerged from trials predominantly involving patients with a median age <65 years.
Method
We reviewed the case notes of all patients in our centre over the age of 65 years who received single agent palliative gemcitabine chemotherapy for pancreatic cancer over a period of 5 years.
Results
Forty-seven patients were suitable for analysis with a median age of 73 years. Median overall survival was 6.2 months. 10 patients (21%) had a dose reduction at the start of chemotherapy and 16 patients (34%) required dose reductions during treatment. The median number of cycles received was 3. 21% of patients died within 60 days of starting chemotherapy and 23% within 30 days of their last treatment dose. On univariate analysis poor prognosis was predicted by the presence of distant metastases (HR, 2.559; 95% CI, 1.39 to 4.7, p=<0.003). Increasing age in this elderly population was not a significant prognostic factor (HR, 0.956; 95% CI, 0.893 to 1.024, p=0.199).
Conclusion
In our centre physician selected elderly patients receiving single agent gemcitabine chemotherapy had an overall survival similar to younger patients selected for participation in landmark clinical trials. Increasing age is not a contraindication to palliative chemotherapy in advanced pancreatic cancer per se.
