Effects of a Sequential Combination of Hyperthermia and Gemcitabine in the Treatment of Advanced Unresectable Pancreatic Cancer : A Retrospective Study

Gemcitabine (GEM) has improved both overall survival and tumor-related symptoms in patients with advanced pancreatic cancer when compared to 5-FU, and is a widely accepted treatment for such patients. However, pancreatic cancers remain extremely resistant to chemotherapy. Empiric chemotherapy based on GEM has had no major successes in treating patients with advanced disease. The objective of this study was to evaluate the response rate, survival, and toxicity of the sequential combination of GEM and hyperthermia. Between November 2005 and November 2007, 7 patients with unresectable pancreatic cancer received sequential combination therapy with GEM and hyperthermia at the Matsushita Memorial Hospital. Data were then compared with 7 historical controls treated with GEM alone at the same institution. There were no significant differences in age, performance status or UICC stage between the GEM plus hyperthermia and GEM monotherapy groups. The disease control rate (CR+PR+SD) was 14.3% for patients treated GEM alone and 57.1% for patients treated with GEM plus hyperthermia. The median survival time was 198 days for patients treated with GEM alone, and 327 days for patients treated with GEM plus hyperthermia. Combination therapy with GEM and hyperthermia thus improves overall survival when compared with GEM monotherapy (p=0.0275). The sequential combination of GEM plus hyperthermia showed a potential therapeutic effect, and was at least as effective as GEM monotherapy. To clarify the effects of this combination therapy, a larger prospective clinical trial is required.