Proven Cancer Indications: Pancreatic

Summary/Conclusion

A retrospective review of 158 patients who received IORT in the setting of biopsy-proven BR/LA PDAC following NAT between 2008 and 2017 was performed. The Kaplan–Meier method was used to analyze progression-free survival (PFS) and overall survival (OS) of FOLFIRINOX treated patients.

Summary/Conclusion

Authors Robert Krempien and Falk Roeder Abstract Despite the important improvements made in the fields of surgery, chemotherapy and radiation therapy, pancreatic cancer remains one of the most lethal malignancies. Improved outcomes with novel chemotherapy regimes led again to increased attention on the role of localized radiotherapy, since local tumor progression causes significant morbidity and mortality … Continued

Summary/Conclusion

Patients with borderline-resectable pancreatic ductal adenocarcinoma have historically poor outcomes with surgery followed by adjuvant chemotherapy. Evaluation of a total neoadjuvant approach with highly active therapy is warranted.

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

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.

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.

Summary/Conclusion

From this joint analysis emerges the fact that preoperative radiotherapy increases the effects of IORT in terms of local control and overall survival.

Summary/Conclusion

A treatment strategy employing IOERT has resulted in long-term survival in 8 of 150 patients with unresectable pancreatic cancer.