Adjuvant radiotherapy for pancreatic cancer: rationale and results

Pancreatic cancer is a highly aggressive disease with a poor prognosis. The mainstay of curative treatment remains surgical resection. Adjuvant chemotherapy has been clearly shown to improve survival. Yet because local-regional recurrence after surgery is the predominant pattern of failure, chemoradiation is often used as a component of treatment. Despite several prospective, randomized trials evaluating adjuvant chemoradiation, controversy persists as to whether it confers a survival benefit. Here we review the rationale for adjuvant chemoradiation and the results of the major studies evaluating the impact of postoperative radiotherapy on disease control and patient survival.