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	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Choti, M. A. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear Related Article PubMed Citation

ABSTRACT

Background The effect of adjuvant treatment on survival in pancreatic cancer is unclear. We report the final results of the European Study Group for Pancreatic Cancer 1 Trial and update the interim results.

Methods In a multicenter trial using a two-by-two factorial design, we randomly assigned 73 patients with resected pancreatic ductal adenocarcinoma to treatment with chemoradiotherapy alone (20 Gy over a two-week period plus fluorouracil), 75 patients to chemotherapy alone (fluorouracil), 72 patients to both chemoradiotherapy and chemotherapy, and 69 patients to observation.

Results The analysis was based on 237 deaths among the 289 patients (82 percent) and a median follow-up of 47 months (interquartile range, 33 to 62). The estimated five-year survival rate was 10 percent among patients assigned to receive chemoradiotherapy and 20 percent among patients who did not receive chemoradiotherapy (P=0.05). The five-year survival rate was 21 percent among patients who received chemotherapy and 8 percent among patients who did not receive chemotherapy (P=0.009). The benefit of chemotherapy persisted after adjustment for major prognostic factors.

Conclusions Adjuvant chemotherapy has a significant survival benefit in patients with resected pancreatic cancer, whereas adjuvant chemoradiotherapy has a deleterious effect on survival.

Source Information

From the Department of Surgery, Liverpool University, Liverpool, United Kingdom (J.P.N., H.H.); the Cancer Research U.K. Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom (D.D.S., J.A.D., D.J.K.); the University of Heidelberg, Heidelberg, Germany (H.F., M.W.B.); the Surgical Department, University of Verona, Verona, Italy (C.B., M.F., P.P.); University Hospital of Surgery, Ulm, Germany (H.B.); Barcelona University Hospital, Barcelona, Spain (L.F.-C.); the Department of Surgery, Agia Olga Hospital, Athens, Greece (C.D.); the Service de Chirurgie Digestive et Générale, Hôpital Tenon, Paris (F.L.); the Department of Gastroenterology, Mav Hospital, Budapest, Hungary (A.P.); and the Department of Radiotherapy, Queen Elizabeth Hospital, Birmingham, United Kingdom (D.S.).

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Chemotherapy for Pancreatic Cancer
Morris S. L., Beasley M., Leslie M., Crane C. H., Ben-Josef E., Small W. Jr., Bydder S., Spry N., Neoptolemos J. P., Stocken D., Büchler M.
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N Engl J Med 2004; 350:2713-2715, Jun 24, 2004. Correspondence

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