Adjuvant Radiation for Resected Pancreatic Cancer: Historical Review and Current State

Pancreatic cancer is the third leading cause of cancer-related deaths, projected to become the second leading cause by 2040. Curative intent resection remains the only non-palliative treatment strategy; however, the 5-year overall survival rate remains 20% among resected patients. Postoperative treatments, including radiation therapy, have been studied to improve outcomes for patients, but the data remains inconclusive. Owing to improvements in radiation treatment quality and advancements in systemic therapy to control micrometastatic disease, further research is critical to determine the role of adjuvant radiation therapy in pancreatic cancer patients and to identify which patients derive the most benefit. Herein, we review the role of adjuvant radiation therapy in resected pancreatic ductal adenocarcinoma, evaluate the current state, and discuss future directions.