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Master thesis program in Medicine
Radiation therapy in locally advanced pancreatic cancer: A retrospective population-based
study
Abstract
Background
The overall 5 years survival of pancreatic cancer is very poor. This is due to a largely
asymptomatic disease which is often diagnosed in its later stages, metastatic pancreatic cancer
or locally advanced pancreatic cancer (LAPC) where the tumor has grown over organs and
vessels. The only curative treatment alternative is to surgically remove the tumor.
Unfortunately, this is rarely possible due to advanced growth of the tumor. Therefore, in most
cases, a palliative treatment strategy is the only option. This can consist of chemotherapy as a
monotherapy or in combination with radiotherapy. The radiotherapy can be either in sequence
or concomitant with the chemotherapy, the latter being more commonly used today.
Purpose
To study and compare the overall survival of Swedish LAPC patients with the data from
international studies. Factors that may affect the overall survival were also included in the
study, namely performance status and level of hemoglobin at start of therapy.
Method
Data was collected from the patient records database Melior. Patients treated at Sahlgrenska
University Hospital with the diagnose LAPC were identified beforehand. Being the only
radiation therapy department in the Västra Götaland Region, the patient cohort is regarded as
population based. The total number of patient in the detailed medical records study was 53
and the time of diagnosis ranged between 2004-2013.
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Results
The median overall survival for the 2004-2009 group and 2010-2013 group after radiotherapy
was 7 months and 11 months respectively (year indicating time of diagnosis). The overall
survival of the two Hb groups was 8.4 months for Hb > 125 and 7.1 months for Hb < 125.
Conclusion
The overall survival rates after treatment are in line with the data provided from several
international studies. Furthermore our studies suggest that Hb could be used as a prognostic
marker before treatment in the future. A further investigation on matched patients with only
chemotherapy is suggested.
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