Adjuvant therapy of pancreatic cancer.
Pancreatic adenocarcinoma is one of the most aggressive tumors, with a high potential for early dissemination and a relatively poor sensitivity to radiation therapy and cytotoxic agents. Complete resection of the tumor is currently the only curative option but only 10-15% of patients present with localized, potentially resectable disease at the time of diagnosis. Median overall survival for all resected patients (R0 and R1) averages between 11 and 23 months, 5-year overall survival ranges from 10 to 25% (R0) and 0 to 5% (R1), leading to a case-fatality index of 95%. Despite the latest trend toward adjuvant chemotherapy with gemcitabine due to the results from the Charité Onkologie-001 trial, there is no broad consensus regarding the adjuvant regimen that should be applied. Early data from the European Study Group for Pancreatic Cancer-3(v2) trial revealed no difference in terms of overall survival between 5-fluorouracil/folinic acid and gemcitabine after resection of pancreatic cancer.
Hilbig
Andreas
A
Campus Virchow-Klinikum, Medizinische Klinik M S Hämatologie und Onkologie Augustenburger Platz 1, 13353 Berlin, Germany. andreas.hilbig@charite.de
Oettle
Helmut
H
D000230:Adenocarcinoma / Q000503:physiopathology / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006801:Humans; D010190:Pancreatic Neoplasms / Q000503:physiopathology / Q000628:therapy*; D018714:Radiotherapy, Adjuvant / Q000379:methods; D013534:Survival; D013997:Time Factors; D016896:Treatment Outcome