Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial

  title={Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial},
  author={J. P. Neoptolemos and Janet A Dunn and D. D. Stocken and J. Almond and K Link and Hans G. Beger and Claudio Bassi and Massimo Falconi and Paolo Pederzoli and Christos G. Dervenis and Laureano Fern{\'a}ndez‐Cruz and François Lacaine and {\'A} {\'A}kos Pap and David Spooner and D. J. Kerr and Helmut Friess and M. W. B{\"u}chler},
  journal={The Lancet},

A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer.

Adjuvant chemotherapy has a significant survival benefit in patients with resected pancreatic cancer, whereas adjuvant chemoradiotherapy has a deleterious effect on survival.

Adjuvant therapy in pancreatic cancer: historical and current perspectives.

The European Study Group for Pancreatic Cancer (ESPAC)-1 trial demonstrated that the current best adjuvant treatment is chemotherapy using bolus 5-fluorouracil with folinic acid, which is as good or superior to multimodality treatments including intra-operative radiotherapy, adjUvant chemoradiotherapy and neo-adjuvant therapies.

Neoadjuvant preoperative chemoradiation in patients with pancreatic cancer.

Surgical treatment of pancreatic cancer: the role of adjuvant and multimodal therapies.

Fluorouracil vs gemcitabine chemotherapy before and after fluorouracil-based chemoradiation following resection of pancreatic adenocarcinoma: a randomized controlled trial.

The addition of gemcitabine to adjuvant fluorouracil-based chemoradiation was associated with a survival benefit for patients with resected pancreatic cancer, although this improvement was not statistically significant.

Adjuvant chemotherapy with fluorouracil plus folinic acid vs gemcitabine following pancreatic cancer resection: a randomized controlled trial.

Compared with the use of fluorouracil plus folinic acid, gemcitabine did not result in improved overall survival in patients with completely resected pancreatic cancer.

Chemotherapy for pancreatic cancer.

Comparison of Adjuvant Chemotherapy and Chemoradiation Therapy Efficacy for Pancreatic Cancer After R0 Resection: A Propensity Score-Matched Analysis

Considering its efficacy and safety, adjuvant SCT alone might be a reasonable choice over SCT-CRT in R0 resected pancreatic cancer.

Adjuvant Therapy in Pancreatic Cancer

The key to the future of adjuvant therapy in pancreatic cancer will be the identification of novel and effective agents, and better biomarker technology underpinned by translational research which will inform the design of future trials.



Adjuvant radiotherapy and concomitant 5-fluorouracil by protracted venous infusion for resected pancreatic cancer.

Prospectively randomized trial of postoperative adjuvant chemotherapy in patients with high-risk colon cancer.

The data suggest that 5-FU plus levamisole for 6 months should not be used in clinical practice, whereas 6 months of treatment with 5-fu plus leucovorin plus lev amisole is effective.

Pancreatic cancer. Adjuvant combined radiation and chemotherapy following curative resection.

The efficacy of combined radiation and fluorouracil as adjuvant therapy for pancreatic cancer is suggested by a prospective randomized study conducted by the Gastrointestinal Tumor Study Group, which was terminated prematurely because of an unacceptably low rate of accrual.

Adjuvant radiotherapy and 5-fluorouracil after curative resection of cancer of the pancreas and periampullary region: phase III trial of the EORTC gastrointestinal tract cancer cooperative group.

Adjuvant radiotherapy in combination with 5-fluorouracil is safe and well tolerated; routine use of adjuvant chemoradiotherapy is not warranted as standard treatment in cancer of the head of the pancreas or periampullary region.

Pancreaticoduodenectomy for pancreatic adenocarcinoma: postoperative adjuvant chemoradiation improves survival. A prospective, single-institution experience.

Standard adjuvant chemoradiation therapy appears to be indicated for patients treated by pancreaticoduodenectomy for adenocarcinoma of the head, neck, or uncinate process of the pancreas, based on survival data.

Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial.

It is demonstrated that gemcitabine is more effective than 5-FU in alleviation of some disease-related symptoms in patients with advanced, symptomatic pancreas cancer and confers a modest survival advantage over treatment with5-FU.

Intraoperative and postoperative radiotherapy in pancreatic cancer

In conclusion, adjuvant therapies seem to improve survival in patients undergoing resection for pancreatic cancer.