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A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer
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Neoptolemos, J. P., Stocken, D. D., Friess, H., Bassi, C., Dunn, Janet A., Hickey, H., Beger, H., Fernandez-Cruz, L., Dervenis, C., Lacaine, F., Falconi, M., Pederzoli, P., Pap, A., Spooner, D., Kerr, D. J. and Büchler, M. W. (2004) A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. New England Journal Of Medicine , 350 (12). pp. 1200-1210. doi:10.1056/NEJMoa032295 ISSN 0028-4793.
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Official URL: https://doi.org/10.1056/NEJMoa032295
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.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | New England Journal Of Medicine | ||||||
Publisher: | Massachusetts Medical Society | ||||||
ISSN: | 0028-4793 | ||||||
Official Date: | 2004 | ||||||
Dates: |
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Volume: | 350 | ||||||
Number: | 12 | ||||||
Page Range: | pp. 1200-1210 | ||||||
DOI: | 10.1056/NEJMoa032295 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Restricted or Subscription Access |
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