B147
Pancreatic palliative chemotherapy audit across five cancer networks, SWCIS upper GI tumour group
Caroline Archer1, Catherine Cafferkey1, Diana Bailey2
1Portsmouth Hospitals NHS Trust, Portsmouth, UK, 2South West cancer Intelligence Service, Winchester, UK
Background
The majority of patients with pancreatic cancer present with locally advanced or metastatic disease. Chemotherapy can improve quality of life and survival in patients with advanced disease and good performance status. NICE guidelines recommend that gemcitabine should be offered to this group.(1) The UK GEMCAP trial showed significant survival gain with combination treatment. (2) The aim of the audit was to determine whether patients with good performance status are offered chemotherapy and the chemotherapy regime given.
Method
Patients diagnosed with locally advanced, inoperable or metastatic pancreatic cancer with an MDT decision between 1st January 2008 - 30th June 2008 were included. 25 hospitals were invited to participate. Data was collected to a proforma.
Results
Provisional data available from 19 hospitals, providing a total of 271 cases. Mean age was 72 years (41-96). 105 patients (39%) had a biopsy proven diagnosis. 168 patients (62%) were referred to oncology. 111 of those (66%) were offered chemotherapy, but only 79 (71%) started treatment. Single agent gemcitabine was used in 55 (69%) and 23 (29%) had combination treatment. Of the 79 patients starting chemotherapy, only 50 (63%) had a biopsy proven diagnosis. Performance status was recorded in 61% of patients presenting to oncology.
Conclusion
The audit, although provisional and awaiting further data, which will be presented, shows reasonable oncology access and provision of chemotherapy throughout the region, the majority still favouring single agent treatment. Of interest is the low level of biopsy confirmation, in particular, 37% received chemotherapy without a biopsy proven diagnosis.
References
[1] Gemcitabine for the treatment of pancreatic cancer, NICE guidance TA25, www.nice.org.uk , 2001.
[2] D. Cunningham, et al. Phase III randomised comparison of gemcitabine (GEM)
versus gemcitabine plus capecitabine (GEM-CAP) in patients with advanced pancreatic cancer. European Journal of Cancer Supplements Volume 3, No. 4, October 2005
