Inferior Survival of Advanced Pancreatic Cancer Patients Who Received Gemcitabine-Based Chemotherapy but Did Not Participate in Clinical Trials
Background: Advanced pancreatic cancer, even when treated, is highly lethal. The best choice of gemcitabine-based therapy and the prognostic factors affecting the success of treatment remain uncertain. Methods: We identified 159 of 1,475 patients with pancreatic cancer diagnosed in our institution a...
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| Veröffentlicht in: | Oncology 2011-01, Vol.81 (3-4), p.143-150 |
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| creator | Yang, Shih-Hung Kuo, Yu-Hsuan Tien, Yu-Wen Hsu, Chiun Hsu, Chih-Hung Kuo, Sung-Hsin Cheng, Ann-Lii |
| description | Background: Advanced pancreatic cancer, even when treated, is highly lethal. The best choice of gemcitabine-based therapy and the prognostic factors affecting the success of treatment remain uncertain. Methods: We identified 159 of 1,475 patients with pancreatic cancer diagnosed in our institution and receiving gemcitabine-based chemotherapy between January 1995 and June 2007. Univariate and multivariate analyses were used to evaluate the prognostic significance of various clinical parameters for overall survival (OS). Results: The median survival after gemcitabine-based therapy was 5.4 months; 89.9% (n = 143) had ductal adenocarcinoma, 55.3% (n = 88) with stage IV. Gemcitabine alone was given to 60 (38%) patients, and gemcitabine with high-dose infusional fluorouracil (5-FU) with (n = 25) or without (n = 39) oxaliplatin was given to 64 (40%) patients. All regimens correlated with OS (p = 0.042) but not with the response rate (RR; p = 0.3). The overall RR was 11.1%, and all responders had a good performance status (PS). The RRs to gemcitabine with infusional 5-FU, and gemcitabine with oxaliplatin and infusional 5-FU were 5.3 and 20.8%, respectively. In a multivariate analysis, old age, advanced stage, poor PS and no enrollment in clinical trials were associated with inferior survival. Conclusions: The outcome for patients who did not participate in clinical trials, regardless of gemcitabine-based treatment, is still bleak. |
| doi_str_mv | 10.1159/000330817 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmed_primary_22024966</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2623912031</sourcerecordid><originalsourceid>FETCH-LOGICAL-c362t-ac32695f3fd8142e34349998108a351f73290f146d74c3b876afc32cf2d9febf3</originalsourceid><addsrcrecordid>eNpd0V1rFDEUBuAgil2rF96LBKGIF6P5mszksh1tLRQVrXg5ZDInbup8rElmob_Cv9xTdl3BqwOHJ-9Jcgh5ztlbzkvzjjEmJat59YCsuBKyYEKKh2SFbVYIxdUReZLSDbKqVPoxORKCCWW0XpE_l5OHGOZIvy1xG7Z2oLOnp_3WTg56-gVLBJuDo819J2InB5hyoj_WM_0KDsIW3QWMLmTbhQmKM5uw06xhnPMaot3c0m7J9H3o6ac5Y0DEuLCxGWiYaDOEKTgcex2DHdJT8shjgWf7eky-n3-4bj4WV58vLpvTq8JJLXJhnRTalF76vsYXg1RSGWNqzmorS-4rKQzzXOm-Uk52daWtxyPOi9546Lw8Jq93uZs4_14g5XYMycEw2AnmJbWGCy1rWRmUr_6TN_MSJ7xcazTOUiUXiN7skItzShF8u4lhtPG25ay931F72BHal_vApRuhP8i_S0Fwsgc24c_4iD8f0j9XyrLCJHQvdu6XjT8hHsB-zh0ztqF4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>963514512</pqid></control><display><type>article</type><title>Inferior Survival of Advanced Pancreatic Cancer Patients Who Received Gemcitabine-Based Chemotherapy but Did Not Participate in Clinical Trials</title><source>Karger Journals</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Yang, Shih-Hung ; Kuo, Yu-Hsuan ; Tien, Yu-Wen ; Hsu, Chiun ; Hsu, Chih-Hung ; Kuo, Sung-Hsin ; Cheng, Ann-Lii</creator><creatorcontrib>Yang, Shih-Hung ; Kuo, Yu-Hsuan ; Tien, Yu-Wen ; Hsu, Chiun ; Hsu, Chih-Hung ; Kuo, Sung-Hsin ; Cheng, Ann-Lii</creatorcontrib><description>Background: Advanced pancreatic cancer, even when treated, is highly lethal. The best choice of gemcitabine-based therapy and the prognostic factors affecting the success of treatment remain uncertain. Methods: We identified 159 of 1,475 patients with pancreatic cancer diagnosed in our institution and receiving gemcitabine-based chemotherapy between January 1995 and June 2007. Univariate and multivariate analyses were used to evaluate the prognostic significance of various clinical parameters for overall survival (OS). Results: The median survival after gemcitabine-based therapy was 5.4 months; 89.9% (n = 143) had ductal adenocarcinoma, 55.3% (n = 88) with stage IV. Gemcitabine alone was given to 60 (38%) patients, and gemcitabine with high-dose infusional fluorouracil (5-FU) with (n = 25) or without (n = 39) oxaliplatin was given to 64 (40%) patients. All regimens correlated with OS (p = 0.042) but not with the response rate (RR; p = 0.3). The overall RR was 11.1%, and all responders had a good performance status (PS). The RRs to gemcitabine with infusional 5-FU, and gemcitabine with oxaliplatin and infusional 5-FU were 5.3 and 20.8%, respectively. In a multivariate analysis, old age, advanced stage, poor PS and no enrollment in clinical trials were associated with inferior survival. Conclusions: The outcome for patients who did not participate in clinical trials, regardless of gemcitabine-based treatment, is still bleak.</description><identifier>ISSN: 0030-2414</identifier><identifier>EISSN: 1423-0232</identifier><identifier>DOI: 10.1159/000330817</identifier><identifier>PMID: 22024966</identifier><language>eng</language><publisher>Basel, Switzerland: Karger</publisher><subject>Adenocarcinoma - drug therapy ; Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic agents ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Chemotherapy ; Clinical outcomes ; Clinical Study ; Clinical trials ; Clinical Trials as Topic - standards ; Clinical Trials as Topic - statistics & numerical data ; Deoxycytidine - administration & dosage ; Deoxycytidine - analogs & derivatives ; Female ; Fluorouracil - administration & dosage ; Humans ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Organoplatinum Compounds - administration & dosage ; Pancreatic cancer ; Pancreatic Neoplasms - drug therapy ; Pancreatic Neoplasms - mortality ; Pancreatic Neoplasms - pathology ; Participation ; Pharmacology. Drug treatments ; Prognosis ; Republic of Korea - epidemiology ; Treatment Outcome ; Tumors</subject><ispartof>Oncology, 2011-01, Vol.81 (3-4), p.143-150</ispartof><rights>2011 S. Karger AG, Basel</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 S. Karger AG, Basel.</rights><rights>Copyright (c) 2011 S. Karger AG, Basel</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-ac32695f3fd8142e34349998108a351f73290f146d74c3b876afc32cf2d9febf3</citedby><cites>FETCH-LOGICAL-c362t-ac32695f3fd8142e34349998108a351f73290f146d74c3b876afc32cf2d9febf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,2423,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25357081$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22024966$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Shih-Hung</creatorcontrib><creatorcontrib>Kuo, Yu-Hsuan</creatorcontrib><creatorcontrib>Tien, Yu-Wen</creatorcontrib><creatorcontrib>Hsu, Chiun</creatorcontrib><creatorcontrib>Hsu, Chih-Hung</creatorcontrib><creatorcontrib>Kuo, Sung-Hsin</creatorcontrib><creatorcontrib>Cheng, Ann-Lii</creatorcontrib><title>Inferior Survival of Advanced Pancreatic Cancer Patients Who Received Gemcitabine-Based Chemotherapy but Did Not Participate in Clinical Trials</title><title>Oncology</title><addtitle>Oncology</addtitle><description>Background: Advanced pancreatic cancer, even when treated, is highly lethal. The best choice of gemcitabine-based therapy and the prognostic factors affecting the success of treatment remain uncertain. Methods: We identified 159 of 1,475 patients with pancreatic cancer diagnosed in our institution and receiving gemcitabine-based chemotherapy between January 1995 and June 2007. Univariate and multivariate analyses were used to evaluate the prognostic significance of various clinical parameters for overall survival (OS). Results: The median survival after gemcitabine-based therapy was 5.4 months; 89.9% (n = 143) had ductal adenocarcinoma, 55.3% (n = 88) with stage IV. Gemcitabine alone was given to 60 (38%) patients, and gemcitabine with high-dose infusional fluorouracil (5-FU) with (n = 25) or without (n = 39) oxaliplatin was given to 64 (40%) patients. All regimens correlated with OS (p = 0.042) but not with the response rate (RR; p = 0.3). The overall RR was 11.1%, and all responders had a good performance status (PS). The RRs to gemcitabine with infusional 5-FU, and gemcitabine with oxaliplatin and infusional 5-FU were 5.3 and 20.8%, respectively. In a multivariate analysis, old age, advanced stage, poor PS and no enrollment in clinical trials were associated with inferior survival. Conclusions: The outcome for patients who did not participate in clinical trials, regardless of gemcitabine-based treatment, is still bleak.</description><subject>Adenocarcinoma - drug therapy</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic agents</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Chemotherapy</subject><subject>Clinical outcomes</subject><subject>Clinical Study</subject><subject>Clinical trials</subject><subject>Clinical Trials as Topic - standards</subject><subject>Clinical Trials as Topic - statistics & numerical data</subject><subject>Deoxycytidine - administration & dosage</subject><subject>Deoxycytidine - analogs & derivatives</subject><subject>Female</subject><subject>Fluorouracil - administration & dosage</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Staging</subject><subject>Organoplatinum Compounds - administration & dosage</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - drug therapy</subject><subject>Pancreatic Neoplasms - mortality</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Participation</subject><subject>Pharmacology. Drug treatments</subject><subject>Prognosis</subject><subject>Republic of Korea - epidemiology</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0030-2414</issn><issn>1423-0232</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpd0V1rFDEUBuAgil2rF96LBKGIF6P5mszksh1tLRQVrXg5ZDInbup8rElmob_Cv9xTdl3BqwOHJ-9Jcgh5ztlbzkvzjjEmJat59YCsuBKyYEKKh2SFbVYIxdUReZLSDbKqVPoxORKCCWW0XpE_l5OHGOZIvy1xG7Z2oLOnp_3WTg56-gVLBJuDo819J2InB5hyoj_WM_0KDsIW3QWMLmTbhQmKM5uw06xhnPMaot3c0m7J9H3o6ac5Y0DEuLCxGWiYaDOEKTgcex2DHdJT8shjgWf7eky-n3-4bj4WV58vLpvTq8JJLXJhnRTalF76vsYXg1RSGWNqzmorS-4rKQzzXOm-Uk52daWtxyPOi9546Lw8Jq93uZs4_14g5XYMycEw2AnmJbWGCy1rWRmUr_6TN_MSJ7xcazTOUiUXiN7skItzShF8u4lhtPG25ay931F72BHal_vApRuhP8i_S0Fwsgc24c_4iD8f0j9XyrLCJHQvdu6XjT8hHsB-zh0ztqF4</recordid><startdate>20110101</startdate><enddate>20110101</enddate><creator>Yang, Shih-Hung</creator><creator>Kuo, Yu-Hsuan</creator><creator>Tien, Yu-Wen</creator><creator>Hsu, Chiun</creator><creator>Hsu, Chih-Hung</creator><creator>Kuo, Sung-Hsin</creator><creator>Cheng, Ann-Lii</creator><general>Karger</general><general>S. Karger AG</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20110101</creationdate><title>Inferior Survival of Advanced Pancreatic Cancer Patients Who Received Gemcitabine-Based Chemotherapy but Did Not Participate in Clinical Trials</title><author>Yang, Shih-Hung ; Kuo, Yu-Hsuan ; Tien, Yu-Wen ; Hsu, Chiun ; Hsu, Chih-Hung ; Kuo, Sung-Hsin ; Cheng, Ann-Lii</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-ac32695f3fd8142e34349998108a351f73290f146d74c3b876afc32cf2d9febf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adenocarcinoma - drug therapy</topic><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic agents</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Chemotherapy</topic><topic>Clinical outcomes</topic><topic>Clinical Study</topic><topic>Clinical trials</topic><topic>Clinical Trials as Topic - standards</topic><topic>Clinical Trials as Topic - statistics & numerical data</topic><topic>Deoxycytidine - administration & dosage</topic><topic>Deoxycytidine - analogs & derivatives</topic><topic>Female</topic><topic>Fluorouracil - administration & dosage</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Staging</topic><topic>Organoplatinum Compounds - administration & dosage</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - drug therapy</topic><topic>Pancreatic Neoplasms - mortality</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Participation</topic><topic>Pharmacology. Drug treatments</topic><topic>Prognosis</topic><topic>Republic of Korea - epidemiology</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Shih-Hung</creatorcontrib><creatorcontrib>Kuo, Yu-Hsuan</creatorcontrib><creatorcontrib>Tien, Yu-Wen</creatorcontrib><creatorcontrib>Hsu, Chiun</creatorcontrib><creatorcontrib>Hsu, Chih-Hung</creatorcontrib><creatorcontrib>Kuo, Sung-Hsin</creatorcontrib><creatorcontrib>Cheng, Ann-Lii</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Shih-Hung</au><au>Kuo, Yu-Hsuan</au><au>Tien, Yu-Wen</au><au>Hsu, Chiun</au><au>Hsu, Chih-Hung</au><au>Kuo, Sung-Hsin</au><au>Cheng, Ann-Lii</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inferior Survival of Advanced Pancreatic Cancer Patients Who Received Gemcitabine-Based Chemotherapy but Did Not Participate in Clinical Trials</atitle><jtitle>Oncology</jtitle><addtitle>Oncology</addtitle><date>2011-01-01</date><risdate>2011</risdate><volume>81</volume><issue>3-4</issue><spage>143</spage><epage>150</epage><pages>143-150</pages><issn>0030-2414</issn><eissn>1423-0232</eissn><abstract>Background: Advanced pancreatic cancer, even when treated, is highly lethal. The best choice of gemcitabine-based therapy and the prognostic factors affecting the success of treatment remain uncertain. Methods: We identified 159 of 1,475 patients with pancreatic cancer diagnosed in our institution and receiving gemcitabine-based chemotherapy between January 1995 and June 2007. Univariate and multivariate analyses were used to evaluate the prognostic significance of various clinical parameters for overall survival (OS). Results: The median survival after gemcitabine-based therapy was 5.4 months; 89.9% (n = 143) had ductal adenocarcinoma, 55.3% (n = 88) with stage IV. Gemcitabine alone was given to 60 (38%) patients, and gemcitabine with high-dose infusional fluorouracil (5-FU) with (n = 25) or without (n = 39) oxaliplatin was given to 64 (40%) patients. All regimens correlated with OS (p = 0.042) but not with the response rate (RR; p = 0.3). The overall RR was 11.1%, and all responders had a good performance status (PS). The RRs to gemcitabine with infusional 5-FU, and gemcitabine with oxaliplatin and infusional 5-FU were 5.3 and 20.8%, respectively. In a multivariate analysis, old age, advanced stage, poor PS and no enrollment in clinical trials were associated with inferior survival. Conclusions: The outcome for patients who did not participate in clinical trials, regardless of gemcitabine-based treatment, is still bleak.</abstract><cop>Basel, Switzerland</cop><pub>Karger</pub><pmid>22024966</pmid><doi>10.1159/000330817</doi><tpages>8</tpages></addata></record> |
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| ispartof | Oncology, 2011-01, Vol.81 (3-4), p.143-150 |
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| source | Karger Journals; MEDLINE; Alma/SFX Local Collection |
| subjects | Adenocarcinoma - drug therapy Adenocarcinoma - mortality Adenocarcinoma - pathology Adult Aged Aged, 80 and over Antineoplastic agents Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Chemotherapy Clinical outcomes Clinical Study Clinical trials Clinical Trials as Topic - standards Clinical Trials as Topic - statistics & numerical data Deoxycytidine - administration & dosage Deoxycytidine - analogs & derivatives Female Fluorouracil - administration & dosage Humans Male Medical sciences Middle Aged Multivariate Analysis Neoplasm Staging Organoplatinum Compounds - administration & dosage Pancreatic cancer Pancreatic Neoplasms - drug therapy Pancreatic Neoplasms - mortality Pancreatic Neoplasms - pathology Participation Pharmacology. Drug treatments Prognosis Republic of Korea - epidemiology Treatment Outcome Tumors |
| title | Inferior Survival of Advanced Pancreatic Cancer Patients Who Received Gemcitabine-Based Chemotherapy but Did Not Participate in Clinical Trials |
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