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Adjuvant chemoradiation therapy for pancreatic adenocarcinoma
Journal of the American College of Surgeons, 05/11/09

Merchant NB et al. – Study demonstrates that the benefit of adjuvant chemoradiation therapy (CRT) is seen only in those patients with pancreas adenocarcinoma that have lymph node (LN)-positive disease, regardless of resection margin status. CRT in LN-negative disease may contribute to reduced disease-free survival.

Methods

Aim was to determine if CRT improves survival in pts with resected pancreatic cancer
Exclusion criteria:
- Pts with T4 or M1 disease
- R2 resection margin
- Preoperative therapy, chemotherapy alone, or if adjuvant therapy status was unknown

Results

747 pts; primary analysis performed between pts that had surgery alone (n=374) and those receiving adjuvant CRT (n=299)
Median f/u time was 12.2 mo and 14.5 mo for survivors
Median OS for pts receiving adjuvant CRT was longer than for those undergoing operation alone
Adjuvant CRT demonstrated a survival advantage only among pts who had LN-positive disease vs LN-negative pts
Disease-free survival in pts with LN-negative disease who received adjuvant CRT was worse than in pts who had surgery alone

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