Treatment order can influence survival times.
Pancreatic cancer patients may live months longer if they receive chemotherapy before surgery, a new study has found.
The cancer is one of the most deadly; just 5% of pancreatic cancer patients live five years after a diagnosis.
This study from the Netherlands found chemotherapy before surgery could give patients with a very difficult prognosis more time.
“This is the first randomized clinical trial to show that pre-operative treatment improves outcomes for people with early stages of pancreatic cancer who can have surgery,” said principal investigator Dr Geertjan Van Tienhoven, radiation oncologist at the Academic Medical Center in Amsterdam.
The trial enrolled 246 patients with pancreatic cancer that could be surgically removed. Each was randomly assigned to receive surgery immediately, or chemoradiotherapy for 10 weeks before surgery. The groups received equal amounts of chemotherapy overall.
For patients who immediately underwent surgery, the median survival time was 13.7 months, compared with 17.1 months for those who first received chemotherapy, a roughly 20% improvement.
Also, patients lived longer before the disease returned, at nearly 10 months versus eight months. Patients who first had chemotherapy had a 42% chance of surviving two years, versus 30% for those who had surgery first. Currently, immediate surgery and then chemotherapy is the standard treatment.
On average, according to Cancer Research UK, just one in five pancreatic cancer patients survive one year after diagnosis, and only 5% survive five years.
“Pancreatic cancer is an awful disease in which patients deteriorate and die very soon usually,” said Van Tienhoven. “Many of the patients don’t reach the point where they can get resection [surgery],” he said.
In recent years, prominent victims of the cancer have included the actor Alan Rickman and Apple boss Steve Jobs.
Van Tienhoven said two of his patients had lived four years from the trial, a long survival for such a deadly disease, and one that points toward hope for a cure.
“They have a good quality of life,” he said. “They are gardening, going on holiday and doing everything that you would do.”
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