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Development and controversies of adjuvant therapy for pancreatic cancer |
Wan-Yee Lau and Eric C. H. Lai |
Hong Kong, China
Author Affiliations: Faculty of Medicine, the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China (Lau WY and Lai ECH)
Corresponding Author: Professor Wan-Yee Lau, Professor of Surgery, Faculty of Medicine, the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China (Tel: 852-2632 2626; Fax: 852-2637 7974; Email: josephlau@cuhk.edu.hk) |
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Abstract BACKGROUND: Pancreatic cancer is an aggressive malignancy with a dismal prognosis. Radical surgery provides the only chance for a cure with a 5-year survival rate of 7%-25%. An effective adjuvant therapy is urgently needed to improve the surgical outcome. This review describes the current status of adjuvant therapy for pancreatic cancer, and highlights its controversies.
DATA SOURCES: A Medline database search was performed to identify relevant articles using the keywords "pancreatic neoplasm", and "adjuvant therapy". Additional papers were identified by a manual search of the references from the key articles.
RESULTS: Eight prospective randomized controlled trials (RCTs) on the use of adjuvant chemotherapy and chemoradiation for pancreatic cancer could be identified. The results for adjuvant regimens based on systemic 5-fluorouracil with or without external radiotherapy were conflicting. The recent two RCTs on gemcitabine based regimen gave promising results.
CONCLUSIONS: Based on the available data, no standard adjuvant therapy for pancreatic cancer can be established yet. The best adjuvant regimen remains to be determined in large-scale RCTs. Future trials should use a gemcitabine based regimen.
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