TABLE 1.

A 78-Year-Old Man With Resected Well-Differentiated Adenocarcinoma of the Pancreatic Head, pT1N0M0 With Negative Margin of Resection, and no Evidence of Perineural Invasion

Treatment	Rating	Comments
Observation	4
Chemotherapy alone
5-FU	6	Gemcitabine may have less toxicity
Gemcitabine	8
Multiagent chemotherapy	4
Chemoradiation therapy followed by adjuvant chemotherapy	4
Chemotherapy followed by chemoradiation therapy followed by chemotherapy	6
Chemotherapy × 4–6 mo followed by chemoradiation therapy	6
Dose to tumor bed (Gy)
45/1.8	5
50.4/1.8	8
54/1.8	5
59.4/1.8	3
RT technique
AP/PA photons	2
4–5 field photon	8
3-dimensional conformal plan
IMRT	8	Using atlas and daily image
RT volume		guidance is recommended
Tumor bed alone	5
Tumor bed + nodal basin	8

Postoperative CA19–9 = 80.

Karnofsky performance status of 80.

Rating Scale: 1, 2, 3 usually not appropriate; 4, 5, 6 may be appropriate; 7, 8, 9 usually appropriate.

AP/PA indicates anterior-posterior/posterior-anterior; 5-FU, 5-fluorouracil; IMRT, intensity-modulated RT; RT, radiation therapy.