The effect of adjuvant treatment on survival in pancreatic cancer is unclear.
In this study, physicians from Europe report the final results of the European Study Group for Pancreatic Cancer 1 Trial and update the interim results.
The team evaluated 289 patients with resected pancreatic ductal adenocarcinoma.
They randomized the patients to receive one of 4 treatments:
- Chemoradiotherapy alone (20 Gy over a 2-week period, plus fluorouracil).
- Chemotherapy alone (fluorouracil).
- Both chemoradiotherapy and chemotherapy.
The team's analysis was based on 237 deaths among the 289 patients (82%) and a median follow-up of 47 months.
They found that the estimated 5-year survival rate was 10% in patients in the chemoradiotherapy group. The 5-year survival was 20% in patients who did not receive chemoradiotherapy.
|5-year survival rate in the chemotherapy group was 21%.|
|New England Journal of Medicine|
The 5-year survival rate in the chemotherapy group was 21%. This was compared to 8% in patients who did not receive chemotherapy.
The benefit of chemotherapy persisted after adjustment for major prognostic factors.
Dr John Neoptolemos and colleagues concluded, "Adjuvant chemotherapy has a significant survival benefit in patients with resected pancreatic cancer, whereas adjuvant chemoradiotherapy has a deleterious effect on survival".