NCCN Guidelines for Patients® | Pancreatic Cancer - page 50

48
NCCN Guidelines for Patients
®
Pancreatic Cancer, Version 1.2014
5.2
Treatment guide
Resectable pancreatic cancer
Chart 5.2.2
shows the next tests and treatments that
are recommended after primary treatment with surgery
for resectable pancreatic cancer. Primary treatment
is the first or main treatment given to rid the body of
cancer. Adjuvant treatment is treatment given after
primary treatment to kill any remaining cancer cells.
Tests
Before beginning adjuvant treatment, you will have
a CT scan and CA 19-9 blood test. These tests are
done to check for signs of recurrence—the return
of cancer after treatment. They also check for
metastases—cancer that has spread outside the
pancreas to far sites in the body. Read Part 2 on
page 14 for more test details.
Test results
If the tests show metastases,
then adjuvant
treatment is not recommended. Instead, you will
receive treatment for metastatic pancreatic cancer.
See
Next steps
at the end of this section.
Tests
Test results
Adjuvant treatment
Follow-up
• CT scan
• CA 19-9
No signs of
recurrence or
metastases
Tests show
metastases
Chart 5.2.2 Adjuvant treatment after surgery
Clinical trial (preferred),
Chemotherapy +
Chemoradiation, or
Chemotherapy alone
Testing every 3 to 6 months
for 2 years, and then once
a year with:
• Medical history and
physical exam,
• CA 19-9 level, and
• CT scan
Treatment for
metastastic cancer
Options for chemotherapy alone:
• Gemcitabine,
• 5-FU/leucovorin,
• Continuous infusion 5-FU, or
• Capecitabine
Options for chemotherapy given
before or after chemoradiation:
• Gemcitabine,
• 5-FU/leucovorin, or
• Continuous infusion 5-FU
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