Adjuvant chemotherapy in pancreatic cancer |
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Authors: | Simon R Bramhall and John P Neoptolemos |
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Affiliation: | (1) University Department of Surgery, Queen Elizabeth Hospital, Edgbaston, B15 2TH Birmingham, UK;(2) Department of Surgery, University of Liverpool, Royal Liverpool University Hospital, 5th Floor NCD, Daulby Street, L69 3GA Liverpool, UK |
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Abstract: | Summary There is increasing interest in the use of adjuvant treatment for pancreatic cancer since although postoperative mortality
is much improved, median long-term survival is only on the order of 11–15 mo. Despite a proliferation of studies in advanced
pancreatic cancer indicating a benefit for chemotherapy, there has only been one small randomized adjuvant trial. A combination
of 5-fluorouracil, doxorubicin, and mitomycin-C demonstrated a significantly improved median survival (23 vs 11 mo in controls)
but no significant improvement in 5-yr survival (4 vs 8%, respectively). At present there is insufficient evidence to support
the routine use of adjuvant chemotherapy (even with radiotherapy) outside of controlled trials. What is required is large
randomized trials of adjuvant chemotherapy. A further important question that needs addressing is the role of adjuvant radiotherapy
(with concomitant chemotherapy) with or without sequential chemotherapy. |
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Keywords: | Pancreatic cancer chemotherapy radiotherapy adjuvant resection |
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