Novel strategies using modern radiotherapy to improve pancreatic cancer outcomes: toward a new standard?

Therapeutic Advances in Medical Oncology
Christelle BouchartJean-Luc Van Laethem

Abstract

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most aggressive solid tumours with an estimated 5-year overall survival rate of 7% for all stages combined. In this highly resistant disease that is located in the vicinity of many radiosensitive organs, the role of radiotherapy (RT) and indications for its use in this setting have been debated for a long time and are still under investigation. Although a survival benefit has yet to be clearly demonstrated for RT, it is the only technique, other than surgery, that has been demonstrated to lead to local control improvement. The adjuvant approach is now strongly challenged by neoadjuvant treatments that could spare patients with rapidly progressive systemic disease from unnecessary surgery and may increase free margin (R0) resection rates for those eligible for surgery. Recently developed dose-escalated RT treatments, designed either to maintain full-dose chemotherapy or to deliver a high biologically effective dose, particularly to areas of contact between the tumour and blood vessels, such as hypofractionated ablative RT (HFA-RT) or stereotactic body RT (SBRT), are progressively changing the treatment landscape. These modern strategies are currently being tested in pros...Continue Reading

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Methods Mentioned

BETA
pancreatectomy

Clinical Trials Mentioned

NCT01013649
NCT02676349
NCT01827553
NCT02024009
NCT03523312
NCT03704662
NCT02839343
NCT03777462
NCT01926197
NCT03621644

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