Conclusions from the European Study Group for Pancreatic Cancer adjuvant trial of chemoradiotherapy and chemotherapy for pancreatic cancer.
Pancreatic ductal adenocarcinoma remains one of the most difficult cancers to treat. It is a tumor that tends to present late, and surgical resection is only possible in a minority of patients. After successful surgery, the prognosis is still relatively poor. Attempts at more radical pancreatic resections and extended lymphadenectomy, although feasible without excessive morbidity and mortality, have failed to produce any convincing improvement in survival. During the last few years, therefore, efforts have been directed toward the development of adjuvant therapies in an attempt to improve outcome. This article describes the main trials of adjuvant chemotherapy, chemoradiotherapy, and chemoradiotherapy with follow-on chemotherapy and presents the results of the European Study Group for Pancreatic Cancer (ESPAC) 1 trial and the status of the ESPAC 2 and 3 trials.
Ghaneh
Paula
P
Department of Surgery, University of Liverpool, 5th Floor, UCD Building,Daulby Street, Liverpool L69 3GA, UK.
Neoptolemos
John P
JP
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D021441:Carcinoma, Pancreatic Ductal / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D017321:Clinical Trials, Phase I as Topic; D003131:Combined Modality Therapy; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D011379:Prognosis; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome