NCCN Guidelines for Patients
Pancreatic Cancer, Version 1.2017
Resectable pancreatic cancer
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.
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