The role of radiotherapy in multimodal treatment of pancreatic carcinoma

Radiation Oncology

Table 1 Phase III-studies for adjuvant therapy

Group - Study Year	Patients (n)	Inclusion criteria Resection-Status	Treatment arms	Median overall survival (Months)	p-value	Preoperative imaging
GITSG-1985[18]	49	R0	CRT Observation	21.0 10.9	0.005	No
EORTC-1999[22]	114*	R0	CRT Observation	17.1 12.6	0.099	No
ESPAC-1-2004[17]	289^#	R0 or R1	Cx No Cx^&	21.6 16.9	Not available	No
CONKO-001-2007[19]	368	R0 or R1	Cx Observation	22.1 20.2	0.06	Yes
RTOG 9704 2008[20]	442^	R0 or R1	CRT + GEM CRT + 5-FU	20.6 16.9	0.033	Yes

Abbreviations: 5-FU = 5-fluorouracil, CRT= chemoradiotherapy, Cx= chemotherapy, GEM= gemcitabine, n= number, R0 = clear resection, R1 = microscopically positive margins. Median overall survival rates from five randomized studies in patients with resected pancreatic carcinoma. None of these studies employed postoperative imaging to exclude tumour persistence or distant metastasis. *The EORTC study included 218 patients with periampullary and pancreatic carcinoma. The figures in the table are based upon the 114 patients with pancreatic carcinoma. ^#The ESPAC-1 study included 541 patients, but only 289 were included into the 2 × 2 factorial randomization. Arms: observation, chemotherapy, chemoradiotherapy, chemoradiotherapy followed by chemotherapy. The survival rates are given for the best treatment arm (chemotherapy) and observation. ^&The comparison arm comprises both, patients with observation and patients with chemoradiotherapy. ^The RTOG 9704-study included a total of 442 patients, 380 of them had pancreatic head tumours.

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