How do you justify adjuvant radiotherapy in pancreatic cancer?

Topics: Radiation Oncology • Gastrointestinal Cancers • Liver and Pancreas Tumors

I can't convince the surgeons to refer their patients for adjuvant RT because the prospective data is messy and doesn’t seem to indicate a benefit. The best median survival in the retrospective studies is similar to that in the prospective chemotherapy alone studies (20-23 months).

Answer from: Radiation Oncologist at Academic Institution

Even though it was flawed in every imaginal way, ESPAC1 had a high impact and made post-op chemoradiation experimental. Prior to that, radiation was not based on very much evidence. GITSG was a 40-patient positive study; the EORTC trial was negative. After the ESPAC1, the focus shifted to neoadjuvan...

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Answer from: Radiation Oncologist at Academic Institution

In terms of randomized data, the only positive trial is GITSG. This is so small, accrued over such a long time, and was done such a long time ago, that it cannot be considered compelling evidence for treatment. The EORTC trial had similar results to GITSG, but the results did not reach statistical ...

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