The role of radiation therapy in pancreatic ductal adenocarcinoma in the neoadjuvant and adjuvant settings

Seminars in Oncology
Aaron J FrankeJoseph Herman

Abstract

Pancreatic adenocarcinoma (PCA) is associated with high rates of cancer-related morbidity and mortality. Yet despite modern treatment advances, the only curative therapy remains surgical resection. The adjuvant therapeutic standard of care for PCA in the United States includes both chemotherapy and chemoradiation; however, an optimal regimen has not been established. For patients with resectable and borderline resectable PCA, recent investigation has focused efforts on evaluating the feasibility and efficacy of neoadjuvant therapy. Neoadjuvant therapy allows for early initiation of systemic therapy and identification of patients who harbor micrometastatic disease, thus sparing patients the potential morbidities associated with unnecessary radiation or surgery. This article critically reviews the data supporting or refuting the role of radiation therapy in the neoadjuvant and adjuvant settings of PCA management, with a particular focus on determining which patients may be more likely to benefit from radiation therapy.

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Citations

Dec 15, 2015·Critical Reviews in Oncology/hematology·Nicola SilvestrisStefano Cascinu
Jul 1, 2015·International Journal of Surgery·P SperlonganoA Gubitosi
Feb 24, 2017·American Journal of Clinical Oncology·William E JonesUNKNOWN Expert Panel on Radiation OncologyGastrointestinal
Feb 11, 2016·World Journal of Clinical Oncology·Rosella SpadiMaria Antonietta Satolli
Dec 29, 2016·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Kimberly PerezBrian M Wolpin
Jun 3, 2021·International Journal of Molecular Sciences·Aditi Kothari, Matthew J Flick

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