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A Randomized Trial of Chemoradiotherapy and Chemotherapy after Resection of Pancreatic Cancer
Open accessAbstract
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.
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Metadata
- Authors
- Neoptolemos, J. P., Stocken, D. D., Friess, H., Bassi, C., Dunn, J. A., Hickey, H., Beger, H., Fernandez-Cruz, L., Dervenis, C., Lacaine, F., Falconi, M., Pederzoli, P., Pap, A., Spooner, D., Kerr, D. J., & Büchler, M. W.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2004-03-18
- Volume
- 350
- Issue
- 12
- Pages
- 1200-1210
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2047318784
- Cited by
- 2,716
- References
- 2
- FWCI
- 52.44
- Type
- journal article
- Language
- en
- Open access
- green
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