Treatment of locally advanced pancreatic cancer: the role of radiation therapy.

Abstract

Pancreatic cancer remains associated with an extremely poor prognosis.

Surgical resection can be curative, but the majority of patients present with locally advanced or metastatic disease.

Treatment for patients with locally advanced disease is controversial.

Therapeutic options include systemic therapy alone, concurrent chemoradiation, or induction chemotherapy followed by chemoradiation.

We review the evidence to date regarding the treatment of locally advanced pancreatic cancer (LAPC), as well as evolving strategies including the emerging role of targeted therapies.

We propose that if radiation is used for patients with LAPC, it should be delivered with concurrent chemotherapy and following a period of induction chemotherapy.

Full Text

• DOI - (DOI)
• Swets Information Services - full-text online
• OhioLINK Electronic Journal Center - full-text online
• Elsevier Science - full-text online
• EBSCO - full-text online

Subjects

• Antineoplastic Agents
• Antineoplastic Combined Chemotherapy Protocols
• Chemoradiotherapy
• Humans
• Pancreatic Neoplasms
• Radiation-Sensitizing Agents
• Radiotherapy
• Randomized Controlled Trials as Topic
• Receptor, Epidermal Growth Factor

Similar articles

• Treatment of locally advanced unresectable pancreatic cancer: a 10-year experience. (2012-04-19)
• Induction chemotherapy selects patients with locally advanced, unresectable pancreatic cancer for optimal benefit from consolidative chemoradiation therapy. (2007-06-25)
• Evaluation of predictive variables in locally advanced pancreatic adenocarcinoma patients receiving definitive chemoradiation. (2012-01-01)
• Stereotactic body radiation therapy with concurrent full-dose gemcitabine for locally advanced pancreatic cancer: a pilot trial demonstrating safety. (2013-03-01)
• Chemoradiotherapy in the management of locally advanced pancreatic carcinoma: a qualitative systematic review. (2009-04-30)
• Duodenal toxicity after fractionated chemoradiation for unresectable pancreatic cancer. (2012-11-29)
• Prognostic Significance of Carbohydrate Antigen 19-9 in Unresectable Locally Advanced Pancreatic Cancer Treated With Dose-Escalated Intensity Modulated Radiation Therapy and Concurrent Full-Dose Gemcitabine: Analysis of a Prospective Phase 1/2 Dose Escalation Study. (2012-12-19)
• Phase II clinical trial of induction chemotherapy with fixed dose rate gemcitabine and cisplatin followed by concurrent chemoradiotherapy with capecitabine for locally advanced pancreatic cancer. (2012-07-18)
• Induction gemcitabine and oxaliplatin therapy followed by a twice-weekly infusion of gemcitabine and concurrent external-beam radiation for neoadjuvant treatment of locally advanced pancreatic cancer: a single institutional experience. (2013-01-07)

Authors

• Kimberly Johung
• Muhammad Wasif Saif
• Bryan W Chang

Publication date

2012-01-16

Journal

Journal topics

• Radiobiology

Language

Eng.

Copyright

Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut 06520-8040, USA.

Release reference

Int J Radiat Oncol Biol Phys. 2012 Feb;82(2):508-18

Related books

• Books of Antineoplastic Agents
• Books of Antineoplastic Combined Chemotherapy Protocols
• Books of Chemoradiotherapy
• Books of Pancreatic Neoplasms
• Books of Radiation-Sensitizing Agents
• Books of Radiobiology
• Books of Radiotherapy
• Books of Randomized Controlled Trials as Topic
• Books of Receptor, Epidermal Growth Factor