Discussion
colorectal cancer, toxicity, pain, non-resectable, weight loss
COLORECTAL CANCER
The optimal treatment of frail patients with PC is understudied, which is counterintuitive to the fact that the majority are in poor PS and/or elderly. The design of this study was inspired by studies in vulnerable patients with colorectal cancer showing improved PFS and more manageable toxicity with reduced dose combination chemotherapy as compared to full dose single-drug treatment [Equally important to the lifes of very poor prognosis patients is how QoL is affected by treatment. In the Burris trial, patients treated with Gem had a greater clinical benefit score (derived from the measurement of pain, functional impairment and weight loss) as compared to 5-FU [In conclusion, single-drug gemcitabine has for more than thirty years been the main treatment option for vulnerable patients with non-resectable PC, but the impact on outcome is modest. If improved efficacy and sustained tolerability with reduced dose combination chemotherapy can be demonstrated, this could be changing future practice.