Multimodality management of localized pancreatic cancer

Despite improvements in surgical management, only a minority of patients en joy long-term survival following pancreaticoduodenectomy for adenocarcinoma of the pancreas. Adjuvant therapy consisting of 5-fluorouracil and irradia tion has improved median and 5-year survival rates; however, at least one t hird of eligible patients do not receive postoperative adjuvant therapy bec ause of delayed recovery following pancreaticoduodenectomy. This has led to the development of treatment schedules incorporating the delivery of syste mic therapy and/or chemoradiation prior to surgery. This article briefly ou tlines the history of adjuvant therapy for adenocarcinoma of the pancreas a nd reviews the available literature on neoadjuvant therapy for localized pa ncreatic cancer including investigational therapies under clinical trial ev aluation.