Pre- and post-operative chemoradiation therapies for pancreatic cancers

Due to a high incidence of local recurrence, the long-term outcome after resection of locally advanced pancreatic cancer is still pessimistic. Many previous reports showed that locoregional control was partly improved by intraoperative radiation or postoperative chemoradiation, while others suggested its insufficient effects for patients with R1- or R2-resections. Therefore some recent authors have recommended preoperative chemoradiation for more promising results in advanced pancreatic cancer. Since patient survival is influenced not only by local control but also by distant (the liver is the most common) metastases, we should develop other strategies that can prevent liver metastases, in addition to the combination of chemoradiation with sur-