(Press-News.org) Among patients with pancreatic cancer who had surgery for removal of the cancer, treatment with the drug gemcitabine for 6 months resulted in increased overall survival as well as disease-free survival, compared with observation alone, according to a study in the October 9 issue of JAMA.
"Pancreatic cancer is a disease with a poor prognosis, mainly because of the inability to detect the tumor at an early stage, its high potential for early dissemination, and its relatively poor sensitivity to chemotherapy or radiation therapy," according to background information in the article. Even after complete removal of the tumor, the vast majority of patients relapse within 2 years, leading to a 5-year survival rate of less than 25 percent. No consensus has been reached on a standard treatment approach for additional therapy. Gemcitabine-based chemotherapy is standard treatment for advanced pancreatic cancer, but its effect on survival after surgery has not previously been demonstrated.
Helmut Oettle, M.D., Ph.D., of the Charite-Universitatsmedizin Berlin, Germany, and colleagues conducted follow-up of a randomized trial that previously reported improvement in disease-free survival with adjuvant (in addition to surgery) gemcitabine therapy to determine if this treatment improved overall survival. Patients with macroscopically (observation made by the unaided eye) completely removed pancreatic cancer entered the study between July 1998 and December 2004 in 88 hospitals in Germany and Austria; follow-up ended in September 2012. Patients were randomly assigned to either adjuvant gemcitabine treatment for 6 months or to observation alone.
A total of 368 patients were randomized, and 354 were eligible for intention-to-treat-analysis. By September 2012, 308 patients (87.0 percent) had relapsed. The median (midpoint) follow-up time was 136 months (11.3 years). The median disease-free survival was 13.4 months in the treatment group compared with 6.7 months in the observation group.
By the end of the follow-up period, 316 patients (89.3 percent) had died and 38 patients were still alive, 23 in the treatment group and 15 in the observation group. The researchers found a statistically significant difference in overall survival between the study groups, with a median of 22.8 months in the gemcitabine group compared with 20.2 months in the observation group. There was also a statistically significant absolute 10.3 percent improvement in the 5-year overall survival rate (20.7 percent vs. 10.4 percent) and a 4.5 percent improvement in the 10-year survival rate (12.2 percent vs. 7.7 percent), compared with observation alone.
"[These] data show that among patients with macroscopic complete removal of pancreatic cancer, the use of adjuvant gemcitabine for 6 months compared with observation resulted in increased overall survival as well as disease-free survival. These findings support the use of gemcitabine in this setting," the authors conclude.
###
(doi:10.l001/jama.2013.279201; Available pre-embargo to the media at http://media.jamanetwork.com)
Editor's Note: This trial was supported in part by a grant from Lilly Germany. The study was further supported by the German Cancer Society and promoted by a research grant from the Charite-Universitatsmedizin Berlin. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, etc.
Chemotherapy drug improves survival following surgery for pancreatic cancer
2013-10-09
ELSE PRESS RELEASES FROM THIS DATE:
Recommended treatment regimen for bone metastases not widely used
2013-10-09
Justin E. Bekelman, M.D., of the University of Pennsylvania Perelman School of Medicine, Philadelphia, and colleagues conducted a study to examine whether single-fraction radiation treatment, shown to be as effective as multiple-fraction treatment with less potential for harm, has been incorporated into routine clinical practice for Medicare beneficiaries with prostate cancer and at what cost savings. Single-fraction radiotherapy is where a large dose of radiation is given in one session; with multiple-fraction radiotherapy, radiation is delivered in smaller doses over ...
Penn study shows the high costs of unnecessary radiation treatments for terminal cancer patients
2013-10-09
PHILADELPHIA -- For cancer patients dealing with the pain of tumors that have spread to their bones, doctors typically recommend radiation as a palliative therapy. But as in many areas of medicine, more of this treatment isn't actually better. Medical evidence over the past decade has demonstrated that patients with terminal cancer who receive a single session of radiotherapy get just as much pain relief as those who receive multiple treatments. But despite its obvious advantages for patient comfort and convenience – and the associated cost savings – this so-called single-fraction ...
Researchers find link between aircraft noise and heart disease
2013-10-09
Previous studies of exposure to aircraft noise have examined the risk of hypertension, but few have examined the risk of cardiovascular disease and results are inconsistent. So researchers based in London set out to investigate the risks of stroke and heart disease in relation to aircraft noise among 3.6 million residents living near London Heathrow, one of the busiest airports in the world.
They compared hospital admissions and mortality rates for stroke, coronary heart disease, and cardiovascular disease from 2001-05 in 12 London Boroughs and nine districts west of ...
Fear of missing bowel cancer may be exposing patients to unnecessary risks, say experts
2013-10-09
Professor Geir Hoff and colleagues in Norway, argue that we need more evidence about the malignant potential of benign lesions to be sure that the risks of removing them do not outweigh the benefits of screening.
Bowel cancer screening has increased the detection of benign polyps (fleshy growths on the lining of the colon or rectum). The most common polyps found during screening are adenomas and guidelines recommend that they are removed.
However, data show that less than 5% of adenomas develop into colorectal cancer, suggesting that 95% of procedures may be exposing ...
Aircraft noise linked to higher rates of heart disease and stroke near London Heathrow Airport
2013-10-09
Risks of hospital admissions and deaths from stroke, heart and circulatory disease are higher in areas with high levels of aircraft noise, a study has found.
Researchers at Imperial College London and King's College London compared data on day- and night-time aircraft noise with hospital admissions and mortality rates among a population of 3.6 million people living near Heathrow airport.
The risks were around 10 to 20 per cent higher in areas with highest levels of aircraft noise compared with the areas with least noise.
The findings are published in the British Medical ...
Growing bacteria keep time, know their place
2013-10-09
VIDEO:
Growth of a bacterial colony (green) over about 60 hours is shown. The blue "on " signal spreads outward from the center; red represents the "off " signal triggered over time.
Click here for more information.
DURHAM, N.C. -- Working with a synthetic gene circuit designed to coax bacteria to grow in a predictable ring pattern, Duke University scientists have revealed an underappreciated contributor to natural pattern formation: time.
In a ...
Older people exposed to aircraft noise may face greater risk of hospitalization from heart problems
2013-10-09
Boston, MA — Older people exposed to aircraft noise, especially at high levels, may face increased risk of being hospitalized for cardiovascular disease, according to a new study from Harvard School of Public Health (HSPH) and Boston University School of Public Health (BUSPH). Researchers found that, on average, zip codes with 10-decibel higher aircraft noise had a 3.5% higher cardiovascular hospital admission rate.
It is the first major study to estimate the association between residential exposure to aircraft noise and cardiovascular hospitalizations, using data on ...
New technique enables accurate, hands-free measure of heart and respiration rates
2013-10-09
Augusta, Ga. - A simple video camera paired with complex algorithms appears to provide an accurate means to remotely monitor heart and respiration rates day or night, researchers report.
The inexpensive method for monitoring the vital signs without touching a patient could have major implications for telemedicine, including enabling rapid detection of a heart attack or stroke occurring at home and helping avoid sudden infant death syndrome, according to a study published in the journal PLOS ONE.
It also may enable untethered, more realistic monitoring of laboratory ...
Definitive imaging study finds no link between venous narrowing and multiple sclerosis
2013-10-09
A study led by Dr. Anthony Traboulsee of the University of British Columbia and Vancouver Coastal Health to see whether narrowing of the veins from the brain to the heart could be a cause of multiple sclerosis has found that the condition is just as prevalent in people without the disease.
The results, published in the U.K. medical journal The Lancet, call into question a controversial theory that MS is associated with a disorder proponents call chronic cerebrospinal venous insufficiency (CCSVI).
The study used both ultrasound and catheter venography (an x-ray of the ...
Research uncovers new details about brain anatomy and language in young children
2013-10-09
PROVIDENCE, R.I. [Brown University] — Researchers from Brown University and King's College London have gained surprising new insights into how brain anatomy influences language acquisition in young children.
Their study, published in the Journal of Neuroscience, found that the explosion of language acquisition that typically occurs in children between 2 and 4 years old is not reflected in substantial changes in brain asymmetry. Structures that support language ability tend to be localized on the left side of the brain. For that reason, the researchers expected to see ...