How Long Can I Survive With Pancreatic Cancer?

by | Oct 29, 2025 | Newest Pancreatic Cancer Treatment, Pancreatic Cancer, Pancreatic Cancer Treatment

A Safety Study of Intraoperative Radiation Therapy Following Stereotactic Body Radiation Therapy and Multi-Agent Chemotherapy in the Treatment of Localized Pancreatic Adenocarcinoma

In this blog we talk about a new treatment approach for localized pancreatic cancer, but first let’s go over some basics: How long someone can live with pancreatic cancer varies greatly depending on the stage at diagnosis, with some people living years or even becoming long-term survivors. Statistical survival rates are based on averages and may not reflect an individual’s specific prognosis, which can be influenced by many factors, including age, overall health, and treatment response. 

Survival rates by stage
Survival rates are often measured by the percentage of people who are still alive five years after their diagnosis. 
  • Localized: If the cancer is confined to the pancreas, the 5-year survival rate is 44%. Surgical removal is often possible at this stage, offering the best chance for long-term survival.
  • Regional: When the cancer has spread to nearby tissues or lymph nodes, the 5-year survival rate is 16%.
  • Distant: For metastatic cancer, which has spread to other parts of the body (most commonly the liver), the 5-year survival rate is only 3%. Over half of all patients are diagnosed at this stage. 
Factors that influence prognosis
Several factors can influence a person’s life expectancy with pancreatic cancer, including: 
  • Response to treatment: How well the tumor responds to chemotherapy, radiation, or other therapies is a major factor.
  • Treatments received: Adjuvant chemotherapy after surgery and newer combination drug regimens have been shown to improve survival outcomes for certain patients.
  • Tumor biology: The tumor’s genetic profile can influence how it behaves and its response to therapy. Targeted therapies are available for patients with specific genetic mutations.
  • Overall health: A person’s general health, nutritional status, and physical condition can affect their tolerance for treatment and recovery.
  • Age at diagnosis: Patients diagnosed at a younger age tend to have a better prognosis. 
Improving chances of survival
While the statistics may seem discouraging, treatment advances and an individualized approach offer increasing hope for patients. 
  • Seek specialized care: Patients who receive treatment at major medical centers with extensive experience treating pancreatic cancer tend to have better outcomes.
  • Get genetic and biomarker testing: This helps identify specific genetic mutations in the tumor, which may guide treatment decisions and lead to more effective targeted therapies.
  • Consider clinical trials: Clinical research offers access to the latest therapies and can lead to significantly better outcomes for some patients.
  • Receive supportive (palliative) care: Management of symptoms and supportive care, in addition to standard treatments, can improve a person’s quality of life and overall prognosis. 
  • AS PROMISED HERE’S THE LATEST RESEARCH ON A NEW TREATMENT BEING TRIED AT JOHNS HOPKINS MEDICAL CENTER IN BALTIMORE, MD 
  • Abstract

Purpose/Objective(s)

In patients with borderline resectable and locally advanced pancreatic cancer (BRPC/LAPC) who are candidates for surgical resection, pre-operative radiation has been associated with high rates of margin negative resection. However, when only gross disease and involved vasculature are targeted with pre-operative radiation, local recurrence rates are high, exceeding 40%. The majority of local failures occur in the “Triangle” volume (TV), defined by extrapancreatic neural tract anatomy at risk. Targeting the TV can reduce local failures to as low as 20%. We subsequently opened a prospective trial to explore a strategy for dose-escalation to the TV involving intraoperative radiation therapy (IORT) to the TV following pre-operative SBRT. We report safety outcomes from this pilot study, and early local control outcomes.

Materials/Methods

A total of 20 patients were enrolled on this study. Following multi-agent chemotherapy, patients were treated with pre-operative SBRT to 40 Gy in 5 fractions to gross disease, involved vasculature, and the TV. Following SBRT, patients were surgically explored. If gross total resection was achieved, patients were treated to the TV to 15 Gy in 1 fraction using Ir-192, prescribed to the surface of a Freiburg flap applicator. The total BED10 to the TV was 109.5 Gy. Primary endpoint was post-operative complication rate, defined by as the rate of Clavien Dindo Grade IIIA or higher complications within the first 90 days following surgery as compared to a historical rate of 25% without pre-operative radiation. Secondary endpoints included post-operative complications > 90 days following surgery, local progression-free survival (LPFS), overall survival, distant metastasis-free survival, and progression-free survival. We report on safety outcomes and early local control data.

Results

Of the 20 patients who were enrolled on the study, median age was 64 years (range: 43-79 years) and 14 (70%) were male. The median follow-up was 11.1 months. A total of 13 (65%) patients had BRPC, while 7 (35%) patients had LAPC. Chemotherapy regimens consisted of FOLFIRINOX and gemcitabine plus nab-paclitaxel for a median duration of 4.5 months (range, 2.5-6 months). The rate of Clavien Dindo Grade > IIIA toxicity was 15% (3/20). No patients experienced post-operative mortality. The 1 year LPFS was 95%. Only one patient has experienced a local failure in the TV, which occurred on the left of the superior mesenteric artery (SMA) in the region of radiation dose falloff.

Conclusion

Intra-operative radiation to the TV following pre-operative SBRT was feasible and safe, without increase in 90-day post-operative complication rate compared to historical data and without post-operative mortality events. Early local control rates in the TV appear excellent, with the exception of one failure in a region of dose falloff. Additional follow-up is needed to understand long term toxicity and other oncologic endpoints. This approach may warrant further investigation in a phase II setting.