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The outlook for patients with pancreatic cancer has beengrim.There have been major advances in the surgicaltreatment of pancreatic cancer,leading to a dramaticreduction in post-operative mortality from thedevelopment of high volume specialized centres.Thisstimulated the study of adjuvant and neoadjuvanttreatments in pancreatic cancer includingchemorediotherapy and chemotherapy.Initial protocolshave been based on the original but rather small GITSGstudy first reported in 1985.There have been two largeEuropean trials totalling over 600 patients(EORTC andESPAC-1)that do not support the use of chemoradiationas adjuvant therapy.A second major finding from theESPAC-1 trial(541 patients randomized)was some but notconclusive evidence for a survival benefit associated withchemotherapy.A third major finding from the ESPAC-1trial was that the quality of life was not affected by theuse of adjuvant treatments compared to surgery alone.The ESPAC-3 trial aims to assess the definitive use ofadjuvant chemotherapy in a randomized controlled trial of990 patients.
The outlook for patients with pancreatic cancer has beengrim.There have been major advances in the surgicaltreatment of pancreatic cancer,leading to a dramatic reduction in post-operative mortality from the development of high volume specialized centres.Thisstimulated the study of adjuvant and neoadjuvanttreatments in pancreatic cancer includingchemorediotherapy And chemotherapy.Initial protocolshave been based on the original but rather small GITSGstudy first reported in 1985.There have been two largeEuropean trials totalling over 600 patients(EORTC andESPAC-1)that do not support the use of chemoradiationas adjuvant therapy.A second majorfinding From the ESPAC-1 trial(541 patients randomized) was some but notconclusive evidence for a survival benefit associated withchemotherapy.A third major finding from the ESPAC-1trial was that the quality of life was not affected by the use of adjuvant items compared to cancer alone. The ESPAC-3 trial aims to assess the definitive use ofadjuvant c Hemotherapy in a randomized controlled trial of990 patients.