Minn. — Radiation therapy was associated with a lower risk
of cancer recurrence in pancreatic cancer surgery patients,
making it, like chemotherapy, an important addition to
treatment, Mayo Clinic research found.
radiotherapy helps patients after pancreatic cancer surgery
has been a long-standing question, and the findings suggest
that it does, says senior author Dr. Christopher Hallemeier, a
radiation oncologist at the Mayo Clinic Cancer Center. The
study is published in the American Society for Radiation
Oncology’s International Journal of Radiation Oncology,
researchers studied 458 patients who had pancreatic cancer
surgery at Mayo Clinic between March 1987 and January 2011. Of
those patients, 378 received chemotherapy and radiation
therapy after surgery, and 80 had only chemotherapy after
percent of those who received chemotherapy and radiation after
surgery had no recurrence of cancer within the area targeted
by the radiation, the tumor bed and lymph nodes, within five
years after diagnosis. That compared with 68 percent of those
who had chemotherapy only following their operations.
Additionally, patients who received radiotherapy had longer
past five years or so, the trend has been toward providing
chemotherapy and radiation before surgery in an increasing
number of patients with operable pancreatic cancer, Hallemeier
says. He and his colleagues plan research to study the benefit
of that, but first wanted to address the longtime question of
whether radiation helps after surgery.
role of radiation therapy in operable pancreatic cancer has
been somewhat controversial. There have been some studies that
have shown a benefit and some studies that have not shown a
benefit," Hallemeier says. "Our large study suggests
that adding radiation treatment in combination with surgery
and chemotherapy reduces the rate of cancer recurrence."
cancer is the fourth-leading cause of cancer death, and it is
on the rise. About 50,000 people are diagnosed with pancreatic
cancer each year in the U.S., and in about half, the cancer
has spread elsewhere in the body, ruling out surgery.
Historically, only about 7 percent of pancreatic cancer
patients have lived at least five years after diagnosis.
about 15 percent of patients have cancer isolated within the
pancreas, making them candidates for an operation to remove
the tumor. In the other 35 percent, the cancer involves
critical blood vessels outside the pancreas; in some cases,
especially with chemotherapy and radiation before surgery,
operations are complex but possible.
black and white, ‘surgery yes or no’ that historically has
been the first approach, that’s being blurred. We’re
realizing that there are patients in the middle of the
spectrum who may be candidates for surgery," Hallemeier
says. "With tailored approaches to treatment before
surgery, for example using chemotherapy first to see how the
tumor responds, and then selectively using radiation, I think
we can personalize treatment for patients who are most likely