Radiation Therapy Lowers Risk of Cancer Recurrence in Patients Undergoing Pancreatic Surgery
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. Whether radiotherapy helps patients after pancreatic cancer surgery has been a long-standing question, and the findings suggest that it does, said senior author Christopher Hallemeier, MD, a radiation oncologist at the Mayo Clinic Cancer Center. The study is published by Merrell et al in the International Journal of Radiation Oncology, Biology, Physics.
Study Findings
The 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 their operations.
Approximately 80% 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 5 years after diagnosis. That compared with 68% of those who had chemotherapy only following their operations. Additionally, patients who received radiotherapy had longer survival times.
Over the past 5 years or so, the trend has been toward providing chemotherapy and radiation before surgery in an increasing number of patients with operable pancreatic cancer, Dr. Hallemeier said. 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.
“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,” Dr. Hallemeier said. “Our large study suggests that adding radiation treatment in combination with surgery and chemotherapy reduces the rate of cancer recurrence.”
Only about 15% of patients with pancreatic cancer have cancer isolated within the pancreas, making them candidates for an operation to remove the tumor. In the other 35%, the cancer involves critical blood vessels outside the pancreas; in some cases, especially with chemotherapy and radiation before surgery, operations are complex but possible.
“The 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,” Dr. Hallemeier said. “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 to benefit.”
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
