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NCCN Guidelines for Patients



Pancreatic Cancer, Version 1.2017


Treatment guide

Borderline 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 using 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 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


Next steps

After completing adjuvant treatment, if follow-up tests

show a local recurrence or metastases, see Guide 12

for treatment recommendations.