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Mayo research weighs in on post-surgical radiation for pancreatic cancer 'controversy'

by Gus Iversen, Editor in Chief | January 06, 2016
Rad Oncology Population Health Radiation Therapy Risk Management
For years, the jury has been out on whether or not radiation therapy after surgery improves outcomes for pancreatic cancer patients — but a new study is weighing in with a verdict.

According to research from the Mayo Clinic, adding radiation therapy to the regimen of chemotherapy and surgery for pancreatic cancer does indeed reduce the likelihood of recurrence and yield better outcomes.

With his team, Dr. Christopher Hallemeier, a radiation oncologist at the Mayo Clinic Cancer Center and study author, examined 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.

Of the patients who received both post-surgical treatments, 20 percent had recurrence within the target area — the tumor bed and lymph nodes — within five years of their diagnosis.

That compared favorably with the percentage of patients who experienced recurrence after only receiving chemotherapy — 32 percent.

In addition to that, the researchers determined that patients who received radiation therapy along with chemotherapy lived longer.

"The 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 said in a statement, adding that this new study adds weight to the argument in favor of it.

Over the past five years or so, Hallemeier said operable pancreatic cancer treatment has also trended toward providing chemotherapy and radiation before surgery in an increasing number of patients. He and his colleagues intend to turn their attention to that practice in the future, and shed new light on the value in outcomes.

Only about 15 percent of pancreatic cancers are isolated within the pancreas. Another 35 percent of them involve critical blood vessels outside the pancreas, but surgical removal may still be possible with the aid of chemotherapy and radiation.

"The black and white, 'surgery yes or no' that historically has been the first approach, that's being blurred," said Hallemeier. With individually tailored approaches, "we're realizing that there are patients in the middle of the spectrum who may be candidates for surgery."

Pancreatic cancer is the fourth leading cause of cancer death in the world and, with 50,000 new cases of pancreatic cancer diagnosed every year in the U.S. alone, finding better ways to treat the disease is a major concern.

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