Is there a role for chemoradiotherapy in the treatment of pancreatic carcinoma?

Abstract

Pancreatic adenocarcinoma is the fifth leading cause of cancer-related death in the United States. In spite of advancements in surgical treatments, nearly 80% of patients with localised pancreatic cancer die of recurrent or metastatic disease when treated with surgery alone. Therefore, efforts to alter the patterns of recurrences 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. Utilizing a preoperative approach, overall treatment time is reduced, a greater proportion of patients receive all components of the therapy and patients with rapidly progressive disease are spared the side-effects of surgery. This paper examines the factors pertinent to clinical trial design for pancreatic cancer and reviews the existing data supporting adjuvant and neoadjuvant therapy for potentially resectable disease and chemoradiotherapy in the advanced disease.