Combining chemotherapy with radiation therapy after the surgical removal of cancer in the pancreas improves survival

Patients with pancreatic cancer, a historically difficult-to-treat cancer with poor survival rates, may benefit from treatments studied in an international, multi-center research trial.

Results of the study, conducted by researchers at the Comprehensive Cancer Center of Wake Forest University Baptist Medical Center and the Centre Hospitalier Lyon Sud in France, have shown that combining chemotherapy with radiation therapy after the surgical removal of cancer in the pancreas may significantly improve survival. The study is published in the August issue of British Journal of Cancer.

"This study built on previous research that showed that the use of a particular chemotherapy agent (gemcitabine) plus radiation therapy might improve survival rates for patients with this devastating cancer," said A. William Blackstock, M.D., associate professor of radiation oncology at Wake Forest Baptist and lead investigator of the study.

The study was initiated to evaluate a course of treatment involving the combination of six weeks of daily radiation therapy to the upper abdomen, concurrent with twice-weekly doses of gemcitabine, followed by two cycles of maintenance doses of gemcitabine alone.

Between June 1999 and October 2003, 46 patients were evaluated in the study. The majority (70 percent) had advanced pancreatic cancer (known as T-3/ T-4) with involvement of the lymph nodes.

The median survival for all the patients in the study was 18.3 months, compared to a national average of 11 months for patients having surgery alone. Sixty-nine percent of the patients were alive at one year and 24 percent were alive at three years.

"The results of our study are promising because they may reflect not only longer survival of these patients, but also an improved local-regional control of the disease. In addition, because lower doses of gemcitabine were used, it proved to be a less toxic approach to treatment," said Blackstock.

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