The role of adjuvant chemoradiation in the treatment of pancreatic cancer

The high rates of mortality due to pancreatic cancer have shown minimal improvement over the past few decades. Even in the most favorable subset of patients, those who are able to receive a pancreatoduodenectomy, outcomes are poor. In addition to high rates of distant metastases, pancreatic cancer is locally aggressive, with high recurrence rates postresection. The role of adjuvant treatment using chemoradiation has been shown to improve local control and survival in pancreatic cancer, but its role remains unclear compared with chemotherapy alone given the high rates of distant failure. This review will present the historically important trials utilizing adjuvant chemoradiation, discuss more contemporary studies, and outline the future direction and results of more recent reports utilizing novel chemotherapeutic agents and advanced radiotherapy techniques in the adjuvant setting.