Intraoperative Radiotherapy in the Era of Intensive Neoadjuvant Chemotherapy and Chemoradiotherapy for Pancreatic Adenocarcinoma

Treatment Use

Electron IORT

Cancer Indication

Pancreatic

Number of Patients

68

Summary/Conclusion

Objectives Improved outcomes with FOLFIRINOX or gemcitabine with nab-paclitaxel in the treatment of metastatic pancreatic adenocarcinoma (PDAC) have prompted incorporation of these regimens into neoadjuvant treatment of locally advanced unresectable PDAC. Whereas some patients remain unresectable on surgical exploration, others are able to undergo resection after intensive neoadjuvant treatment. We evaluated outcomes and toxicity associated … Continued

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Sophie Cai, et al., “Updated Long-Term Outcomes and Prognostic Factors for Patients With Unresectable Locally Advanced Pancreatic Cancer Treated With Intraoperative Radiotherapy at the Massachusetts General Hospital, 1978 to 2010” (2014)

Treatment Use

Electron IORT

Cancer Indication

Pancreatic

Number of Patients

194

Summary/Conclusion

Well-selected patients with LAPC with small tumors and low Charlson age-comorbidity indices can achieve good long-term survival outcomes with a treatment regimen that incorporates chemotherapy and IORT.

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Ashman JB, et al. “Preoperative chemoradiation and IOERT for unresectable or borderline resectable pancreas cancer” (2013)

Treatment Use

Mobetron

Cancer Indication

Pancreatic

Number of Patients

31

Summary/Conclusion

Long term survival and disease control are achievable in select patients with borderline resectable or locally unresectable pancreas cancer when gross total surgical resection is achieved after preopCRT. Improvements in imaging continue to allow better selection of patients in whom gross total resection alone or plus IOERT may be feasible after preoperative treatment for initially unresectable or borderline resectable pancreas cancers.

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