Advertisement

pp 1-7 | Cite as

Pancreatic Cancer

  • Ann Raldow
  • Jennifer Wo
Chapter
Part of the Medical Radiology book series

Abstract

Pancreatic cancer is an aggressive disease with high rates of disease-related mortality due to high rates of systemic disease spread. The role of radiation therapy for pancreatic cancer has been controversial to date. There have been significant advancements in effective systemic therapy regimens and radiation treatment delivery techniques, however, that are promising. This chapter aims to review all pertinent literature regarding the role of radiation therapy for pancreatic cancer.

References

  1. Abrams RA, Lillemoe KD, Piantadosi S (2001) Continuing controversy over adjuvant therapy of pancreatic cancer. Lancet 358:1565–1566CrossRefPubMedGoogle Scholar
  2. Chang DT et al (2009) Stereotactic radiotherapy for unresectable adenocarcinoma of the pancreas. Cancer 115:665–672CrossRefPubMedGoogle Scholar
  3. Chauffert B et al (2008) Phase III trial comparing intensive induction chemoradiotherapy (60 Gy, infusional 5-FU and intermittent cisplatin) followed by maintenance gemcitabine with gemcitabine alone for locally advanced unresectable pancreatic cancer. Definitive results of the 2000-01 FFCD/SFRO study. Ann Oncol 19:1592–1599CrossRefPubMedGoogle Scholar
  4. Chuong MD et al (2013) Stereotactic body radiation therapy for locally advanced and borderline resectable pancreatic cancer is effective and well tolerated. Int J Radiat Oncol Biol Phys 86:516–522CrossRefPubMedGoogle Scholar
  5. Cohen SJ et al (2005) A randomized phase III study of radiotherapy alone or with 5-fluorouracil and mitomycin-C in patients with locally advanced adenocarcinoma of the pancreas: Eastern Cooperative Oncology Group study E8282. Int J Radiat Oncol Biol Phys 62:1345–1350CrossRefPubMedGoogle Scholar
  6. Crane CH, Willett CG (2009) Stereotactic radiotherapy for pancreatic cancer? Cancer 115:468–472CrossRefPubMedGoogle Scholar
  7. Crane CH et al (2011) Phase II trial of cetuximab, gemcitabine, and oxaliplatin followed by chemoradiation with cetuximab for locally advanced (T4) pancreatic adenocarcinoma: correlation of Smad4(Dpc4) immunostaining with pattern of disease progression. J Clin Oncol 29:3037–3043CrossRefPubMedPubMedCentralGoogle Scholar
  8. Didolkar MS et al (2010) Image-guided stereotactic radiosurgery for locally advanced pancreatic adenocarcinoma results of first 85 patients. J Gastrointest Surg 14:1547–1559CrossRefPubMedGoogle Scholar
  9. Gudjonsson B (1987) Cancer of the pancreas. 50 years of surgery. Cancer 60:2284–2303CrossRefPubMedGoogle Scholar
  10. Hammel P, Huguet F, Van Laethem J-L, Goldstein D, Glimelius B (2013) Comparison of chemoradiotherapy (CRT) and chemotherapy (CT) in patients with a locally advanced pancreatic cancer (LAPC) controlled after 4 months of gemcitabine with or without erlotinib: final results of the international phase III LAP 07 study. J Clin Oncol 31(18 suppl):LBA4003a. (201AD)CrossRefGoogle Scholar
  11. Hoyer M et al (2005) Phase-II study on stereotactic radiotherapy of locally advanced pancreatic carcinoma. Radiother Oncol J Eur Soc Ther Radiol Oncol 76:48–53CrossRefGoogle Scholar
  12. Huguet F, Girard N, Guerche CS et al (2009) Chemoradiotherapy in the management of locally advanced pancreatic carcinoma: a qualitative systematic review. J Clin Oncol 27(13):2269CrossRefPubMedGoogle Scholar
  13. Huguet F et al (2007) Impact of chemoradiotherapy after disease control with chemotherapy in locally advanced pancreatic adenocarcinoma in GERCOR phase II and III studies. J Clin Oncol 25:326–331CrossRefPubMedGoogle Scholar
  14. Iacobuzio-Donahue CA et al (2009) DPC4 gene status of the primary carcinoma correlates with patterns of failure in patients with pancreatic cancer. J Clin Oncol 27:1806–1813CrossRefPubMedPubMedCentralGoogle Scholar
  15. Kalser MH, Ellenberg SS (1985) Pancreatic cancer. Adjuvant combined radiation and chemotherapy following curative resection. Arch Surg 120:899–903CrossRefPubMedGoogle Scholar
  16. Klinkenbijl JH et al (1999) Adjuvant radiotherapy and 5-fluorouracil after curative resection of cancer of the pancreas and periampullary region: phase III trial of the EORTC gastrointestinal tract cancer cooperative group. Ann Surg 230:776–782.; discussion 782–784CrossRefPubMedPubMedCentralGoogle Scholar
  17. Koong AC et al (2005) Phase II study to assess the efficacy of conventionally fractionated radiotherapy followed by a stereotactic radiosurgery boost in patients with locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys 63:320–323CrossRefPubMedGoogle Scholar
  18. Loehrer PJ et al (2011) Gemcitabine alone versus gemcitabine plus radiotherapy in patients with locally advanced pancreatic cancer: an eastern cooperative oncology group trial. J Clin Oncol 29:4105–4112CrossRefPubMedPubMedCentralGoogle Scholar
  19. Mahadevan A et al (2010) Stereotactic body radiotherapy and gemcitabine for locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys 78:735–742CrossRefPubMedGoogle Scholar
  20. Mahadevan A et al (2011) Induction gemcitabine and stereotactic body radiotherapy for locally advanced nonmetastatic pancreas cancer. Int J Radiat Oncol Biol Phys 81:e615–e622CrossRefPubMedGoogle Scholar
  21. Moertel CG et al (1981) Therapy of locally unresectable pancreatic carcinoma: a randomized comparison of high dose (6000 rads) radiation alone, moderate dose radiation (4000 rads + 5-fluorouracil), and high dose radiation + 5-fluorouracil: the Gastrointestinal Tumor Study Group. Cancer 48:1705–1710CrossRefPubMedGoogle Scholar
  22. Neoptolemos JP et al (2001) Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial. Lancet 358:1576–1585CrossRefPubMedGoogle Scholar
  23. Neoptolemos JP et al (2004) A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med 350:1200–1210CrossRefPubMedGoogle Scholar
  24. Nitecki SS, Sarr MG, Colby TV, van Heerden JA (1995) Long-term survival after resection for ductal adenocarcinoma of the pancreas. Is it really improving? Ann Surg 221:59–66CrossRefPubMedPubMedCentralGoogle Scholar
  25. Piorkowski RJ et al (1982) Pancreatic and periampullary carcinoma. Experience with 200 patients over a 12 year period. Am J Surg 143:189–193CrossRefPubMedGoogle Scholar
  26. Polistina F et al (2010) Unresectable locally advanced pancreatic cancer: a multimodal treatment using neoadjuvant chemoradiotherapy (gemcitabine plus stereotactic radiosurgery) and subsequent surgical exploration. Ann Surg Oncol 17:2092–2101CrossRefPubMedGoogle Scholar
  27. Regine WF et al (2008) Fluorouracil vs gemcitabine chemotherapy before and after fluorouracil-based chemoradiation following resection of pancreatic adenocarcinoma: a randomized controlled trial. JAMA 299:1019–1026CrossRefPubMedGoogle Scholar
  28. Schellenberg D et al (2008) Gemcitabine chemotherapy and single-fraction stereotactic body radiotherapy for locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys 72:678–686CrossRefPubMedGoogle Scholar
  29. Schellenberg D et al (2011) Single-fraction stereotactic body radiation therapy and sequential gemcitabine for the treatment of locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys 81:181–188CrossRefPubMedGoogle Scholar
  30. Siegel R, Ma J, Zou Z, Jemal A (2014) Cancer statistics, 2014. CA Cancer J Clin 64:9–29CrossRefPubMedGoogle Scholar
  31. Tempero MA et al (2014) Pancreatic adenocarcinoma, version 2.2014: featured updates to the NCCN guidelines. J Natl Compr Cancer Netw 12:1083–1093CrossRefGoogle Scholar
  32. Tepper J, Nardi G, Sutt H (1976) Carcinoma of the pancreas: review of MGH experience from 1963 to 1973. Analysis of surgical failure and implications for radiation therapy. Cancer 37:1519–1524CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.University of California, Los AngelesLos AngelesUSA
  2. 2.Massachusetts General HospitalBostonUSA

Personalised recommendations