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Adjuvant Treatment Improves Pancreatic Cancer Survival

Studies examine preoperative and postoperative treatment

WEDNESDAY, July 23 (HealthDay News) -- Four new studies show that the addition of chemotherapy and radiation before or after surgery for pancreatic cancer can improve survival, according to an editorial in the July 20 issue of the Journal of Clinical Oncology.

Nipun Merchant, M.D., and Jordan Berlin, M.D., from Vanderbilt University Medical Center in Nashville, Tenn., review four articles in the issue examining perioperative therapy of resectable pancreatic cancer. Two articles examined survival after adjuvant chemotherapy and radiation. One article from Mayo Clinic researchers led by Michele M. Corsini, M.D., reviewed data from 472 patients with pancreatic adenocarcinoma who underwent complete resection with negative margins and showed that adjuvant radiation and chemotherapy improved overall survival. Another article from Joseph M. Herman, M.D., of Johns Hopkins University, and colleagues found that adjuvant concurrent fluorouracil-based chemotherapy and radiation after pancreaticoduodenectomy in 908 patients with pancreatic adenocarcinoma improved survival.

In another study, Douglas B. Evans, M.D., and researchers from the University of Texas M.D. Anderson Cancer Center found that preoperative gemcitabine plus radiation in 86 patients with pancreatic head/uncinate process adenocarcinoma followed by restaging and surgery if no disease progression occurs can improve survival in some patients. In the final study from the same group, led by Gauri Varadhachary, M.D., the investigators found that preoperative gemcitabine and cisplatin chemotherapy plus chemoradiation and pancreaticoduodenectomy in 90 patients with stage I/II pancreatic adenocarcinoma did not improve survival over preoperative gemcitabine-based chemoradiation alone.

"How do we use these four articles to move into the future?" Merchant and Berlin ask. "First, some form of adjuvant therapy is of benefit and currently designed trials will hopefully clarify the options we have available."

Berlin reports financial relationships with the pharmaceutical industry.

Abstract - Corsini
Abstract - Herman
Abstract - Evans
Abstract - Varadhachary

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