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N Engl J Med. 2004 Mar 18;350(12):1200-10.

A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer.

Author information

  • 1Department of Surgery, Liverpool University, Liverpool, United Kingdom.

Erratum in

  • N Engl J Med. 2004 Aug 12;351(7):726.

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.

Copyright 2004 Massachusetts Medical Society

Comment in

PMID:
15028824
[PubMed - indexed for MEDLINE]
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