Adjuvant therapy in pancreatic cancer

Table 1 Survival following surgery and adjuvant chemotherapy for pancreatic cancer

Series	Period	Number		Regimen	Median survival (months)	Actuarial survival (%)
		Total	PDAC			1 year	3 year	5 year
Splinter et al[43]	1977-1984	36	18				28
	1980-1984	16	9	5-FU/DOX/MMC			24
Livingstone et al[44]	N/A	285	285	N/A				9
Bakkevold et al*[45]	1984-1987	30	23	5-FU/DOX/MMC	23	70	70	4
		31	24		11	45	30	8
Baumel et al[46]	1982-1988	43	43	Not specified	12
	1982-1988	527	527		12

5-FU = 5-fluorouracil; DOX = doxorubicin; MMC = mitomycin C; * randomised cont rolled trial, PDAC = pancreatic ductal adenocarcinoma.

Table 2 Survival following surgery and radiotherapy for pancreatic cancer

Series	Year	Number	EBRT (Gy)	IORT (Gy)	Median survival (months)	Actuarial survival (%)
						1 year	3 year	5 year
Willett et al[32]	1993	16 (nm)	40-50		21			29
		23 (pm)	40-50		11			0
Johnstone et al[53]	1993	26	45-55	20	18
Zerbi et al[21]	1994	43		12.5-20	19	71	7
		47			12	49	10
Di Carlo et al[54]	1997	27			14
		27		12.5-2017
Dobelbower et al[55]	1997	14			6.5	15	0	0
		6		10-20	9	50	35	33
		14	50-67		14.5	64	28	0
		10	27-54	10-25	18	70	10	0
Farrell et al[56]	1997	14	60	12-25	16	62	22	15
Hishinuma et al[57]	1998	34	24 EBRT	13 EBRT + IOR	13	59		19
Klinkenbijl et al*[58]	1999	54pdc			12.6			10
		60pdc	40		17.1			20
Mehta et al[59]	2000	52	45-54	8 IORT	32	75	38
Lee et al[60]	2000	22					47
		13	49				81

EBRT = external beam radiotherapy; IORT = intraoperative radiotherapy; nm = negative resection margin; pm = positive resection margin; pdc = pancreatic ductal adenocarcinoma.

Table 3 Adjuvant regional therapy for pancreatic cancer

Series	Year	Number	Regimen	Median survival (months)	Actuarial survival (%)
					1 year	3 year	5 year
Ishikawa et al[65]	1994	20	HAI + PVI			54
Ozaki et al[66]	1994	24	IORT + HAI +/- PVI				32
Link et al[67]	1997	20	CAI	21
		29		9.3
Beger et al[68]	1999	24	CAI	23			54 (4 year)
		nd		10.5			9.5 (4 year)

HAI = hepatic arterial infusion; PVI = portal vein infusion; CAI = coeliac artery infusion

Table 4 Neoadjuvant therapy for pancreatic cancer

Series	Year	Number	Regimen	Resection rate		Positive resection margin (n)	Median survival (months)	Actuarial survival (%)
				n	%			3 year	5 year
Ishikawa et al[70]	1994	23	EBRT	17/23	74				22
Coia et al[71]	1994	27	EBRT + 5-FU + MMC	13/27	48	0/13	16	43
Staleyet al[72]	1996	39	EBRT + 5-FU + IORT	39/39	100	7/39	19		19 (4 year)
Spitz et al[73]	1997	41	EBRT + 5-FU	41/91	51	5/41	19.2
Hoffman et al[74]	1998	53	EBRT + 5-FU + MMC	24/53	45		15.7
White et al[75]	1999	25	5-FU + EBRT + MMC + CPP	5/25	20
Wanebo et al[76]	2000	14	5-FU + EBRT + CPP	9/14	64
Snady et al[77]	2000	68	EBRT + 5-FU + STREP + CPP	20/68	29		32	32
				48 NR	71		21	13

EBRT = external beam radiotherapy; 5-FU = 5-fluorouracil; MMC = mitomycin C; IORT = intraoperative radiotherapy; STP = streptozocin; CDDP = cisplatinum; FA = folinic acid; DPD = dipyridamole; n = number; CPP = cisplatin; NR = not resectable.

Table 5 Results of combination therapy in patients who have undergone resection for pancreatic cancer

Series	Year	Number	Radiotherapy (Gy)	Chemotherapy	Median survival (months)	Actuarial survival (%)
						1 year	2 year	3 year	5 year
Kalser et al*[81]	1985	21	EBRT 40	5-FU	20	67	42	24	18
		22			11	50	15	7	8
GITSG[82]	1987	30	EBRT 40	5-FU	18		46
Conlon et al[83]	1996	56	EBRT 45	5-FU	20		35
Yeo et al[84]	1997	53			13.5		30
		99	EBRT 40-45	5-FU	21		44
		21	EBRT 50-57	5-FU + FA	17.5		22
UKPACA[85]	1998	35	EBRT 40	5-FU	13	56	38	29	15
Abrams et al[86]	1999	23	EBRT	5-FU + FA	15.9
Paulino et al[87]	1999	30	EBRT	5-FU	26
		8	EBRT		5.5
André et al[88]	2000	10	EBRT	5-FU + FA + CPP	17

EBRT = external bean radiotherapy; 5-FU = 5-fluorouracil; FA = folinic acid; CPP = cisplatin