Radiation Therapy in Pancreatic Cancer
Pancreatic adenocarcinoma is a neoplasm with very poor prognosis due to the biological aggressiveness of this tumor and to the frequently late diagnosis. In fact, in most patients, pancreatic cancer is diagnosed in locally advanced or metastatic stage. Therefore, in the majority of cases, the purpose of therapy is to prolong survival and improve quality of life.
In patients with resectable disease, the standard treatment is surgical resection followed by adjuvant chemotherapy which may eventually combined with postoperative chemoradiation. In locally advanced tumors, the treatment is mainly based on chemotherapy, eventually combined also in this case with concurrent chemoradiation.
Patients with locally advanced tumor undergoing chemoradiation should be accurately reassessed by imaging after the treatment and during the follow-up in order to identify patients who become eligible to surgery, taking into account that the rate of pathological response can improve after 10–20 weeks after radiochemotherapy.
Stereotactic radiotherapy is an emerging technique in locally advanced pancreatic cancer, by allowing satisfactory local control of the disease with very short treatment duration. In metastatic patients, palliative radiotherapy can be used to treat symptoms caused by metastases or primary tumors, again in combination with systemic treatments.
KeywordsPancreatic neoplasms Surgery Chemotherapy Radiotherapy Stereotactic radiotherapy
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