Adjuvant radiotherapy for resected pancreatic cancer: a lack of benefit or a lack of adequate trials?
Surgical resection is the most effective means of controlling nonmetastatic pancreatic cancer, but recurrence rates are high even after complete resection. For several types of tumor of the gastrointestinal tract, combined modality therapy that includes radiation therapy has been shown to reduce the recurrence rate and improve disease-free survival. The use of adjuvant radiotherapy for pancreatic cancer, however, is controversial. Results of the few randomized trials of adjuvant radiotherapy for pancreatic cancer are conflicting. In addition, as pancreatic cancer is associated with high rates of distant recurrence, the additional benefit provided by local therapy has been perceived as questionable. This article reviews the studies--prospective and retrospective--of adjuvant radiotherapy for pancreatic cancer and the issues surrounding the use of this strategy.
Gutt
Ruchika
R
Department of Radiation and Cellular Oncology, University of Chicago, IL 60637, USA.
Liauw
Stanley L
SL
Weichselbaum
Ralph R
RR
D000230:Adenocarcinoma / Q000532:radiotherapy* / Q000601:surgery; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D010190:Pancreatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment