Gemcitabine/5-FU/Leucovorin for thetreatment of pancreatic carcinoma

The efficacy and toxicity of a chemotherapy protocol consisting of Gemcitabine, 5-FU and Leucovorin in patients with different stages of pancreatic cancer was evaluated. Fifty-one chemo-naїve 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 enrolled. With a mean time follow-up of 25 months in the adjuvant group, all 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). Overall mean survival time was 6.5 months (ranged 1.0–15.5). 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. The combination of Gemcitabine with 5-FU and Leucovorin is an active and well-tolerated regimen in patients with all stages of pancreatic cancer, meriting further evaluation in prospective randomized studies. This combination may be considered a valuable alternative to Gemcitabine alone