Adjuvant Radiation Therapy for Distal Pancreatic Cancer: Is There a Role?

Excerpt

Pancreatic cancer is a major cause of cancer-related mortality worldwide. Little progress has been made in improving outcomes over the past 3 decades despite numerous trials encompassing many therapeutic agents and modalities. Except for rare anecdotes, pancreatic cancer is only curable when resection is undertaken. Unfortunately, more than 80% of patients are not resectable with either locally advanced/unresectable or metastatic disease at presentation. In the small percentage of patients who are resected, approximately 20% will survive 5 years, indicating that even “curative” therapy is ultimately palliative in nature.1 5-fluorouracil (5-FU) stood as the backbone of systemic therapeutic regimens in this disease for many years until 1997 when gemcitabine was shown to result in a modest (median 1.3-month) survival benefit over 5-FU in patients with advanced disease. With a corresponding improvement in quality of life measures in patients receiving gemcitabine, this was considered the first major advance in this disease in more than a decade.2 …