NCCN Guidelines for Patients® | Pancreatic Cancer - page 66

64
NCCN Guidelines for Patients
®
Pancreatic Cancer, Version 1.2014
5.4
Treatment guide
Locally advanced unresectable pancreatic cancer
Chart 5.4.2
shows the first-line treatment
recommendations for locally advanced unresectable
pancreatic cancer. First-line treatment is the first
treatment or set of treatments given to control the
cancer. First-line treatment options include a clinical
trial, chemotherapy, chemoradiation, and supportive
care.
Health status rating
Which treatment is recommended for you depends
on your health status rating, also called performance
status. Your health status is a rating by your doctor
based on your overall health, cancer symptoms,
and ability to do daily activities. Good health status
means that your overall health is good. You’re able to
continue doing all of your regular daily activities very
well. You also have very few or very mild symptoms
of the cancer and you’re able to eat well. Poor health
status means that your overall health is poor. You
aren’t able to do your regular daily activities well.
The number and/or severity of cancer symptoms is
increased.
Your health status rating is a very important factor
when choosing the best treatment for you. This
is because healthier patients are able to tolerate
treatments with higher risks of side effects. Certain
treatments and drug combinations have a higher risk
of severe, even lethal, side effects. Your doctor should
explain all of the risks and possible side effects of the
treatments you receive.
Health status rating
First-line treatment
Chart 5.4.2 First-line treatment with drugs
Poor health status
(Overall health is poor,
unable to do normal
daily activities well, and
severe or uncontrolled
cancer symptoms)
Gemcitabine, or
Palliative and best supportive care
Good health status
(Overall health is good,
able to do all normal
daily activities well, few
cancer symptoms, good
pain control, and good
nutrition)
Clinical trial (preferred),
FOLFIRINOX,
Gemcitabine,
Gemcitabine + nab-paclitaxel,
Other gemcitabine-based therapy, or
Capecitabine or continuous infusion 5-FU
Possible
chemoradiation
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