1. R3 이운주/Prof 맹치훈

2. Introduction Pancreatic adenocarcinoma is most lethal cancer, with a 5-year survival rate of less than 5%. Relapsed occurs in 80-85% of patients after tumor resection. Adjuvant treatment has been advocated to reduce relapse and prolong survival after surgery. The major adjuvant treatment include fluorouracil, gemcitabine, chemoradiation, chemoradiation plus fluorouracil or gemcitabine. However, the optimum treatment remains controversial. They aimed to compare these treatment in terms of overall survival after tumor resection and in terms of grade 3-4 toxic effects with a systemic review and random-effects Bayesian network meta-analysis.

3. Methods Search strategy and selection criteria  Systemic review in accordance with PRISMA guidelines. Data extraction an assessment or risk of bias  Patient characteristics  Inclusion and exclusion criteria  Treatment protocol  Outcomes Data synthesis and analysis  Overall survival after resection of pancreatic adenocarcinoma.  Treatment related grade 3-4 hematologic, non-hematological toxic effects.

6. Results

9. Conclusion The network meta-analysis suggested that chemotherapy with fluorouracil or gemcitabine is the optimum adjuvant treatment for pancreatic adenocarcinoma and reduces mortality after tumor resection by about a third. Chemoradiation alone has little benefit, and chemoradiation plus chemotherapy is less effective in prolong survival and more toxic than chemotherapy, especially with chemoradiation plus gemcitabine.