NCCN Guidelines for Patients
Pancreatic Cancer, Version 1.2017
Borderline 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 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
After completing adjuvant treatment, if follow-up tests
show a local recurrence or metastases, see Guide 12
for treatment recommendations.