title: [Adjuvant and additive therapy for cancer of the pancreas].
abstract: Recent advances have been made in the treatment of pancreas cancer. Specialized pancreas centres have reported an increasing rate of resections with reduced postoperative mortality. On account of the highly aggressive nature of pancreas cancer, there is a great challenge in identifying effective therapy concepts for advanced stages of the cancer as well as for the development of resection-associated measures. As large-scale, randomised, controlled studies are lacking, the additive therapy concepts after resection do not have a sufficiently scientific basis. The ESPAC-1 study, which included 600 patients, surpassed all previous studies on adjuvant therapy for pancreas cancer. This study has shown,for example, that the most promising adjuvant chemotherapy with 5-fluorouracil and folic acid leads to an equal if not better result than the multimodal regimen. This regimen can be superseded with the use of Gemcitabine, which will be evaluated in the ESPAC-3 study that includes 990 patients from various European countries including Germany, as well as from Canada and Australia. Participation in the large, phase-3 study therefore plays a key role in the continued development of the management of pancreas cancer.
authors.affiliation: Department of Surgery, Liverpool University, Liverpool, United Kingdom. j.p.neoptolemos@liverpool.ac.uk
authors.forename: J P
authors.initials: JP
authors.lastname: Neoptolemos
authors.forename: M G T
authors.initials: MG
authors.lastname: Raraty
authors.forename: P
authors.initials: P
authors.lastname: Ghaneh
authors.forename: H
authors.initials: H
authors.lastname: Hickey
authors.forename: D D
authors.initials: DD
authors.lastname: Stocken
authors.forename: J A
authors.initials: JA
authors.lastname: Dunn
authors.forename: H
authors.initials: H
authors.lastname: Friess
authors.forename: M W
authors.initials: MW
authors.lastname: Büchler
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D017326:Clinical Trials, Phase III as Topic; D003131:Combined Modality Therapy; D018849:Controlled Clinical Trials as Topic; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use; D005492:Folic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D006397:Hematinics / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008942:Mitoxantrone / Q000008:administration & dosage / Q000627:therapeutic use; D015337:Multicenter Studies as Topic; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D011788:Quality of Life; D011879:Radiotherapy Dosage; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D006397:Hematinics; D003841:Deoxycytidine; D004317:Doxorubicin; D005492:Folic Acid; D008942:Mitoxantrone; D002955:Leucovorin; D005472:Fluorouracil; D000093542:Gemcitabine