Professor Neoptolemos and colleagues investigated the worldwide evidence of the roles of adjuvant chemoradiation and adjuvant chemotherapy on survival in potentially curative resected pancreatic cancer.
The research team identified 5 randomized controlled trials of adjuvant treatment in patients with histologically proven pancreatic ductal adenocarcinoma.
The researchers reported that 4 of the 5 most recent trials provided individual patient data of 875 patients.
The team included previously unpublished follow-up data on 261 patients.
|2 year survival rates is estimated at 30 % with chemoradiation versus 38 % with chemotherapy|
|British Journal of Cancer|
The pooled estimate of the hazard ratio indicated a 25 % significant reduction in the risk of death with chemotherapy.
The investigators estimated median survival at 19 months with chemotherapy and 14 without.
The team also estimated 2 and 5 year survival rates at 38 % and 19 % with chemotherapy, respectively and 28 % and 12 % without.
The pooled estimate of the hazard ratio indicated no significant difference in the risk of death with chemoradiation.
The researchers found that median survivals were 16 months with chemoradiation and 15 without.
In addition, the team showed that the 2 and 5 year survival rates were estimated at 30 % and 12 %, respectively with chemoradiation and 34 % and 17% without.
Subgroup analyses conducted by the researchers, estimated that chemoradiation was more effective and chemotherapy less effective in patients with positive resection margins.
Professor Neoptolemos’ team concludes, “These results show that chemotherapy is effective adjuvant treatment in pancreatic cancer but not chemoradiation.”
“Further studies with chemoradiation are warranted in patients with positive resection margins, as chemotherapy appeared relatively ineffective in this patient subgroup.”