TABLE 2.

A 65-Year-Old Woman With Resected Moderately Differentiated Adenocarcinoma of the Pancreatic Head, pT2N1M0 With Negative Margin of Resection, 1 of 15 Lymph Nodes Involved, and no Evidence of Perineural Invasion

Treatment	Rating	Comments
Observation	2
Chemotherapy alone
5-FU	7
Gemcitabine	8
Multiagent chemotherapy	4
Chemoradiation therapy followed by adjuvant chemotherapy	5	This option may be appropriate but there was disagreement among panel members on the appropriateness rating as defined by the panel’s median rating
Chemotherapy followed by chemoradiation therapy followed by chemotherapy	7
Chemotherapy × 4–6 mo followed by chemoradiation therapy	7
Dose to tumor bed (Gy)
45/1.8	5	This option may be appropriate but there was disagreement among panel members on the appropriateness rating as defined by the panel’s median rating
50.4/1.8	8
54/1.8	7
59.4/1.8	3
RT technique
AP/PA photons	3
4–5 field photon	8
3-dimensional conformal plan
IMRT	8
RT volume
Tumor alone	3
Tumor + nodal basin	8

Postoperative CA19–9 = 120.

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.