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NCCN Guidelines for Patients



Pancreatic Cancer, Version 1.2017


Treatment guide

Resectable pancreatic cancer

Adjuvant treatment

There are 3 main options for adjuvant treatment:



Joining a clinical trial is strongly recommended.

A clinical trial is a type of research that studies

the safety and effectiveness of a new treatment.



Chemotherapy drug options include

gemcitabine alone or in combination with

capecitabine, 5-FU with leucovorin, continuous

infusion 5-FU, or capecitabine alone.



Chemotherapy plus chemoradiation. In this

case, chemotherapy may be given entirely

before chemoradiation, or sometimes both

before and after chemoradiation.

Recommended chemotherapy drugs include

gemcitabine alone or with capecitabine, 5-FU with

leucovorin, continuous infusion 5-FU, or capecitabine

alone. During radiation, chemotherapy may be

added with either fluoropyrimidine (preferred), such

as continuous infusion 5-FU or capecitabine, or



After completing adjuvant treatment, you will have

follow-up tests. Follow-up tests are tests given after

treatment to check how well treatment worked. These

tests look for signs of cancer return (recurrence) or

spread (metastasis) after treatment.

Follow-up tests are recommended every 3 to 6

months for 2 years, and then once every 6 to 12

months. A medical history and physical exam

can help to find signs and symptoms of recurrent

pancreatic cancer early. CA 19-9 is a substance

found in blood and high levels can be caused by

pancreatic cancer. Thus, a CA 19-9 blood test is

recommended as part of follow-up testing. A CT scan

of the abdomen with contrast is also recommended

to look for early signs of cancer recurrence.

Next steps

After completing adjuvant treatment, if follow-up

tests show a recurrence, see Guide 8 for treatment

recommendations. If you didn’t have adjuvant

treatment because tests after surgery found

metastases, you can see Guide 12 for treatment