Strahlentherapeutische Strategien in der multimodalen Therapie des resektablen und nicht resektablen Pankreaskarzinoms

Abstract

Due to the worse prognosis of patients with adenocarcinoma of the pancreas, new combined treatment modalities as adjuvant and neoadjuvant radio-chemotherapy, particularly with more modern chemotherapeutic agents, for patients with resectable and unresectable tumors are under investigation. For some reasons, the neoadjuvant setting seems to be better. However, these results are not proven by prospective randomized clinical trials. Therefore, these trials are necessary to define the treatment of choice in these patients. IORT is a helpful tool to improve local control. However, these aggressive multimodality approaches are only indicated in a minority of patients. In patients with unresectable tumors and good condition, combined radio-chemotherapy remains the treatment of choice.

Significant Increase in Residual DNA Damage as a Possible Mechanism of Radiosensitization by Gemcitabine

“…The widespread use of new techniques such as conformal, three-dimensional or intraoperative radiotherapy and combination of different modalities, including modern chemotherapeutic agents, inspired a great number of studies. The results of combined radiochemotherapy (RCT) were significantly superior to those of radiotherapy alone [30].…”

Current status of biomarker and targeted nanoparticle development: The precision oncology approach for pancreatic cancer therapy

“…For example, FOLFIRINOX (Leucovorin Calcium, Fluorouracil, Irinotecan Hydrochloride and Oxaliplatin), OFF (Oxaliplatin, Fluorouracil and Leucovorin Calcium), Gem-Cisplatin and Gem-Oxaliplatin are four FDA approved drug combinations for PDAC. The other combinations, such as chemotherapy-radiation therapy [85], photoherapy-chemotherapy [69] and gene therapy-chemotherapy [81], have also been investigated. Because each drug kill cancer cells through different mechanisms, these combination therapies usually show improved therapeutic effects compared to the single drug treatment.…”

Radiochemotherapie mit Gemcitabin und Cisplatin bei Pankreaskarzinom – durchführbar und effektiv

“…In Bezug auf die Mortalität steht das Pankreaskarzinom allerdings an fünfter Stelle, was die bisher unbefriedigende Prognose widerspiegelt und den Bedarf, neue Therapiestrategien zu entwickeln [37].…”