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40

NCCN Guidelines for Patients

®

:

Pancreatic Cancer, Version 1.2017

5

Treatment guide

Resectable pancreatic cancer

Adjuvant treatment

There are 3 main options for adjuvant treatment:

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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.

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Chemotherapy drug options include

gemcitabine alone or in combination with

capecitabine, 5-FU with leucovorin, continuous

infusion 5-FU, or capecitabine alone.

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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

gemcitabine.

Follow-up

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

options.