Evaluation of Treatment Outcome and Acute Toxicity in Patients Undergoing Adjuvant Therapy in Ductal Carcinoma Pancreas: A Prospective Observational Study

Abstract

Ductal adenocarcinoma of the pancreas is one of the commonly diagnosed cancers and is a leading cause of cancer mortality in the population. The prognosis of patients even after undergoing a complete resection is generally poor, with a median survival of 13–20 months and a 3-year survival of 30%. Therefore, adjuvant therapies including adjuvant chemoradiation and adjuvant chemotherapy are given in an effort to improve survival. In the authors’ centre, all patients undergoing resection are given adjuvant chemoradiation followed by adjuvant chemotherapy. This study was conducted to evaluate the acute toxicity and treatment outcome (patterns of failure, overall and disease-free survival) of patients undergoing adjuvant therapy in resected carcinoma pancreas. Adjuvant chemoradiation was well tolerated by most patients with resected carcinoma pancreas and all patients completed chemoradiation. Adjuvant chemotherapy was associated with high haematological toxicity, similar to previously published literature. However, treatment interruptions were higher and only 77% patients completed adjuvant chemotherapy. The adjuvant gemcitabine, given on Days 1, 8, and 15, for a 4-weekly schedule was poorly tolerated by the authors’ patient population and there were only fewer interruptions in patients who were switched to the 3-weekly schedule. Inclusion of a greater number of patients and longer follow-up of this study is required to clearly assess the patterns of failure and survival outcomes.