Support. The EORTC 40891 trial used the same randomization as GITSG 91-73, except the Tx arm did not rcv maintenance adj 5-FU for 2 yrs. Median PFS was 17 mos (CRT) vs. 16 mos (observation), NSS; MS was 24 mos (CRT) vs. 19 mos (observation), NSS. For the subset of PCA pts, 5-yr OS was 20% (CRT) vs. 10% (observation) (p = 0.09) (KlinkenbijlJH et al., Ann Surg 1999). Of note, in addition to T1-2N0-1 PCA, 45% of pts had periampullary adenocarcinoma, which were excluded in GITSG 91-73, and generally have better prognosis. Authors concluded that routine adj CRT was not warranted, although statistical reanalysis of this study found a significant survival benefit with adj therapy. (GarofaloMC et al., Ann Surg 2006)