Adjuvant chemoradiotherapy for resected pancreas cancer

Table 1 Trial comparison

Trial/authors, yr	Adjuvant therapy	Patients (n)	Median survival (mo)	Median disease free survival (mo)	Estimated 5-yr survival (%)	P-value
Evidence for adjuvant chemoradiotherapy in randomized trials
GITSG 9173/Kalser et al[4], 1985	Chemoradiotherapy (5-FU)	21	20	11	18	0.035
	No adjuvant therapy	22	11	9	0
EORTC Phase III/Klinkenbijl et al[6], 1999	Chemoradiotherapy (5-FU)	104	24.5a	17.4a	28a	0.099a
			17.1b
	No adjuvant therapy	103	19a	16a	22a	0.049c
			12.6b
RTOG 97-04/Regine et al[9], 2008	Chemoradiotherapy (5-FU)	230	16.9		22d	0.09
	Chemoradiotherapy (gemcitabine)	221	20.5		31d
CONKO Phase III/Oettle et al[13], 2007	Chemotherapy (gemcitabine)	186	22.1	13.4	18	< 0.001e
	No adjuvant therapy	182	20.2	6.9	0	0.06f
Evidence against adjuvant chemoradiotherapy in randomized trials
ESPAC-1/Neoptolemos et al[14], 2004	Chemotherapy (CT) (5-FU)	75	21.6		29	0.05 [(CT/RT), (CT/RT + CT) vs (CT), (no CT/RT)]
	Chemoradiotherapy (CT/RT) (5-FU)	73	19.9		13
	Chemoradiotherapy + chemotherapy (CT/RT + CT) (5-FU)	72	13.9		7	0.009 [(CT), (CT/RT + CT) vs (CT/RT), no (CT/RT)]
	No adjuvant therapy	69	16.9		11
Evidence for adjuvant therapy in large single-institution studies
Johns Hopkins Hospital experience/Herman et al[18], 2008	Chemoradiotherapy (5-FU)	271	21.2		20.1	< 0.001
	No adjuvant therapy	345	14.4		15.4
The Mayo Clinic experience/Corsini et al[19], 2008	Chemoradiotherapy (5-FU)	274	25.2		28	0.001
	No adjuvant therapy	180	19.2		17
The Johns Hopkins Hospital & Mayo Clinic Collaborative study/Hsu et al[20], 2010	Chemoradiotherapy (5-FU)	583	21.1		22.3	< 0.001
	No adjuvant therapy	509	15.5		16.1

^aBased on the two-sided log-rank test;

^bResults for patients with pancreatic cancer only, differences not significant;

^cBased on the reanalysis using the one-sided log-rank test;

^dThree years survival;

^eMedian disease-free survival;

^fOverall survival. GITSG: Gastrointestinal Tumor Study Group; 5-FU: 5-fluorouracil; EORTC: European Organisation for Research and Treatment of Cancer; RTOG: Radiation Therapy Oncology Group; CONKO: Charité Onkologie; ESPAC-1: European Study Group for Pancreatic Cancer Trial; CT: Chemotherapy; RT: Radiation therapy.