Patients with cancer of the pancreas benefit from additional chemotherapy when the tumour has been removed. This measure more than doubles the number of patients living on for five years and longer. More detail can be found in the report on the biggest ever multi-centre study on the treatment of pancreatic cancer, to be published tomorrow in the current issue of the renowned New England Journal of Medicine.
Almost 30 percent of patients receiving post-operative chemotherapy with Fluoruracil lived on for 5 years and longer, as opposed to 11 percent who underwent the operation alone. Additional post-operative chemoradiotherapy brought no benefits.
Over 280 patients have been involved in this study, which extended over the last 10 years. It was conducted by the European Study Group for Pancreatic Cancer, headed by medical centres in Heidelberg and Liverpool. "For the first time, this study provides scientific evidence that additional chemotherapy gives the patients a precious extra lease of life," said Professor Dr. Dr. h.c. Markus W. Büchler, administrative director of the University of Heidelberg's Surgical Hospital and co-author of the article in the New England Journal of Medicine.
Treatment results for pancreatic cancer not very satisfactory so far
Pancreatic cancer is the fifth most frequent instance of death caused by a tumour. In Germany, about 10,000 people come down with this illness every year. So far, the treatment results have not been very satisfactory. Fewer than 10 percent of the people affected live on longer than five years. But patients whose malignant tumour has been detected at an early stage and removed have better prospects. This is possible in about 20 percent of all such cases.
"Earlier, these poor prospects were frequently the reason why no treatment was even attempted," says Professor Büchler. But new surgical methods and the systematic use of chemotherapy mean that such pessimism is no longer justified. The essential prerequisite is that patients be treated at a centre with sufficient experience of the illness and its therapy.
So far, there has been controversy about whether "adjuvant" chemotherapy (additional treatment after resection of the malignant tumour) increases the chances of survival in pancreatic cancer patients, in the same way as has been demonstrated for other forms of cancer. The administration of cell-killer medication is designed to destroy unidentifiable micro-metastases, kill off tumour cells in the blood and lymph streams and prevent the return of the original tumour. "The results of this study will probably make adjuvant chemotherapy a standard feature in future therapy," said Professor Büchler.
In further clinical studies, the European Study Group will be examining how the treatment of pancreatic cancer can be further improved. To this end it will be testing the use of other chemotherapeutic agents in adjuvant therapy.
Professor Dr. Dr. h.c. Markus W. Büchler
Administrative Director of the University Surgical Hospital
University of Heidelberg
phone: 06221/566201 (secretary Ms. Alffermann)
Neoptolemos JP, Buechler MW et al.,
A Randomized Trial of Chemoradiotherapy and Chemotherapy after Resection of Pancreatic Cancer, New England Journal of Medicine 2004;350:1200-10
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