Localized adenocarcinoma of the pancreas: the rationale for preoperative chemoradiation. Oncologist 2002;7(1):34-45
Date
02/21/2002Pubmed ID
11854545DOI
10.1634/theoncologist.7-1-34Scopus ID
2-s2.0-0036174577 (requires institutional sign-in at Scopus site) 81 CitationsAbstract
Pancreatic adenocarcinoma is the fifth leading cause of cancer-related death in the U.S. In spite of advancements in surgical treatment, nearly 80% of patients thought to have localized pancreatic cancer die of recurrent or metastatic disease when treated with surgery alone. Therefore, efforts to alter the patterns of recurrence and improve survival for patients with pancreatic cancer currently focus on the delivery of systemic therapy and irradiation before or after surgery. Postoperative adjuvant therapy appears to improve median survival. However, more than one-fourth of patients do not complete planned adjuvant therapy due to surgical complications or a delay in postoperative recovery of performance status. Utilizing a preoperative (neoadjuvant) approach, overall treatment time is reduced, a greater proportion of patients receive all components of therapy, and patients with rapidly progressive disease are spared the side effects of surgery as metastatic disease may be found at restaging following chemoradiation (prior to surgery). This paper examines the factors pertinent to clinical trial design for resectable pancreatic cancer, and carefully reviews the existing data supporting adjuvant and neoadjuvant therapy for potentially resectable disease.
Author List
Wayne JD, Abdalla EK, Wolff RA, Crane CH, Pisters PW, Evans DBAuthor
Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdenocarcinomaAged
Antineoplastic Combined Chemotherapy Protocols
Chemotherapy, Adjuvant
Humans
Neoplasm Recurrence, Local
Neoplasm Staging
Pancreatic Neoplasms
Pancreaticoduodenectomy
Preoperative Care
Radiotherapy, Adjuvant
