Pancreatic cancer, which generally has a very poor prognosis, is the fourth most common cause of cancer-related deaths. It killed greater than 32,000 Americans last year. Therefore, researchers are investigating methods to improve the outlook.
A large study recently demonstrated that patients who underwent surgical removal of the pancreas, who were given both radiation therapy and chemotherapy afterwards, derived improved survival.
When radiation therapy and/or chemotherapy are administered to a person who has undergone an operation to remove all the visible cancer, it is termed adjuvant therapy. An example of the routine use of adjuvant radiation therapy and chemotherapy is that of a woman who has had a lumpectomy to remove a malignant breast tumor.
Investigators reviewed the records of 472 people who had complete surgical removal of the pancreas. All had negative margins, meaning a rim of normal tissue surrounded the cancer cells. Patients whose disease spread beyond the pancreas or whose disease could not be removed entirely were excluded from the study. Also excluded were patients who had a slow growing variant of pancreatic cancer.
At the end of the review, the records of 454 patients were eligible for analysis. A comparison was then made of those who received adjuvant radiation therapy and chemotherapy concurrently after surgery versus those who did not.
Over half of the patients received adjuvant radiation therapy and chemotherapy (274 out of 454 patients). 50 percent of these survived two years and 28 percent went on to live at least five years.
This data was in stark contrast to one-third (180 out of 454 patients) who received no additional therapy after surgery and whose survival was significantly less; 39 percent at two years and 17 percent at five years, respectively.
In addition, patients who received further chemotherapy after their course of adjuvant concomitant radiation therapy and chemotherapy seemed to have even better survival; 61 percent and 31 percent at two and five years, respectively. However, only 28 of 454 patients received this regimen, so it is premature to draw conclusions from this limited sized population.
Nonetheless, the findings of this study suggest a significant improvement in survival rates for those who undergo adjuvant radiation therapy and chemotherapy after complete removal of pancreatic cancer. More good news is that the incidence of pancreatic cancer has decreased over the past few years.
Dr. Kornmehl is a board certified radiation oncologist at Passaic Beth Israel Regional Medical Center, Passaic, NJ and author of the critically acclaimed consumer health book, “The Best News About Radiation Therapy" (M. Evans, 2004). Her website is http://www.RTSupportDoc.com