Adjuvant Chemoradiotherapy for Pancreatic Adenocarcinoma

While the clinical benefits of adjuvant chemotherapy are well documented in resected pancreatic ductal adenocarcinoma regardless of surgical margin status, the role of adding chemoradiation to adjuvant chemotherapy is an ongoing debate due to the paucity of clinical studies that concurrently incorporated contemporary chemotherapy regimens such as mFOLFIRINOX or gemcitabine/capecitabine with modern day radiation dose fractionation and techniques. Adjuvant chemoradiation should be tailored to individual patients and supported by multidisciplinary discussion. In R1 patients with good performance status following completion of adjuvant mFOLFIRINOX or gemcitabine/capecitabine, adjuvant chemoradiation may be considered with the intent to decrease the risk of local recurrence.