Prognostic factors in patients with locally advanced pancreatic carcinoma receiving chemoradiotherapy

BACKGROUND, The combination of radiation therapy and chemotherapy (chemorad iotherapy [CRT]) has been accepted as standard therapy for patients with lo cally advanced pancreatic carcinoma (PC). This study investigated prognosti c factors in patients with locally advanced PC receiving CRT. METHODS, Fifty-five consecutive patients with locally advanced PC, who rece ived concurrent radiotherapy (50.4 grays) and chemotherapy using 5-fluorour acil or cisplatin, were analyzed retrospectively to investigate prognostic factors. RESULTS. Median survival time and overall survival rates at 1 and 2 years w ere 301 days, 35.1% and 2.4%, respectively By multivariate analysis using t he Cox proportional hazards model, performance status of 0-1 (P < 0.01), ab sence of regional lymph node swelling (P < 0.01), and serum CA 19-9 level o f less than 1000 (P = 0.02) were independent favorable prognostic factors. A prognostic index based on the coefficients of those prognostic factors wa s used to classify patients into three groups with good, intermediate, and poor prognoses. The median survival times for these three groups were 410, 239, and 143 days, respectively (P < 0.01]. CONCLUSIONS. The results may be helpful in predicting life expectancy, dete rmining treatment strategies, and designing future clinical trials. (C) 200 1 American Cancer Society.