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01-08-2017 | Pancreatic cancer | Book chapter | Article

Adjuvant Chemoradiation Therapy for Pancreatic Cancer

Authors: Adeel Kaiser, William F. Regine, Naimish Pandya, Michael C. Garofalo

Publisher: Springer New York

Abstract

Despite newer treatment modalities, overall outcome for pancreatic cancer remains poor and has changed very little during the past 30 years. Surgery remains the mainstay, but delivery of adjuvant postoperative therapy has been shown to be essential for long-term survival. Large, prospective randomized studies have revealed conflicting data on whether chemotherapy alone or combination chemoradiation is optimal. They have also triggered debates regarding the sequencing of adjuvant therapy strategies. Unfortunately, marked discrepancies exist with patient selection as well as trial design among these studies, resulting in inadequate comparisons of their conclusions. Nevertheless, like other gastrointestinal malignancies, it appears that adjuvant combination chemoradiation is superior to chemotherapy alone when the data is critically analyzed. This critical examination of the published data to date is provided in the forthcoming chapter, along with an assessment of what is needed for future trials to determine the optimal adjuvant treatment modality and improve overall outcome for pancreatic cancer patients.

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