Effects of Chemotherapy and Chemoradiotherapy on Survival and Toxicity in Locally Advanced Unresectable Pancreatic Cancer

The optimal treatment for locally advanced, unresectable pancreatic cancer remains controversial. This study aimed to compare the effects of chemotherapy and chemoradiotherapy on survival and toxicity in patients with locally advanced, unresectable pancreatic cancer. A total of 59 patients were retrospectively analyzed. Overall survival (OS), progression-free survival (PFS), and treatment-related toxicities were evaluated. Twenty-five patients received chemotherapy followed by concurrent radiotherapy with gemcitabine, while 34 patients received chemotherapy alone. Survival differences were analyzed using the Kaplan–Meier method and compared with the log-rank test. Survival was significantly improved in the chemoradiotherapy group. Median OS and PFS were 19.27 and 17.09 months, respectively, compared with 12.39 and 7.60 months in the chemotherapy group (p=0.040 and p=0.006). Grade 3–4 gastrointestinal mucositis occurred in 20.8% of patients receiving chemoradiotherapy, while grade 3–4 hematological toxicity was observed in 4–12.5%. In the chemotherapy group, hematological toxicity was 11–14% and gastrointestinal toxicity was 17.6%. No significant difference in toxicity was found between the groups. In conclusion, the findings of our study suggest that chemoradiotherapy may contribute positively to survival in patients with locally advanced unresectable pancreatic cancer.