Unresectable Locally Advanced Pancreatic Cancer: A Multimodal Treatment Using Neoadjuvant Chemoradiotherapy (Gemcitabine Plus Stereotactic Radiosurgery) and Subsequent Surgical Exploration

Abstract

The SBRT method is a promising treatment for LAPC. Local control rates, even compared to historical data from conventional radiotherapy, can be achieved with minimal toxicity. Resectability can also be achieved.

Individually optimized stereotactic radiotherapy for pancreatic head tumors: A planning feasibility study

“…22,23 Furthermore, several authors proposed the use of radiotherapy as preoperative treatment. [24][25][26] The reason is that most patients have a locally advanced and, therefore, unresectable tumor at diagnosis. Typically, the reason for unresectability is the infiltration of the blood vessels close to the pancreas (mainly the superior mesenteric artery and vein and the celiac trunk).…”

Pancreatic cancer and SBRT: A new potential option?

“…Median survival was 10.6 months and 8% of patients became resectable. 28 Numerous other published trials have also looked at the role of SBRT in the treatment of locally advanced pancreatic cancer. [29][30][31][32][33][34][35][36] In Table 1, we present a selected number of studies addressing this topic.…”

The Investigation of 125I Seed Implantation as a Salvage Modality for Unresectable Pancreatic Carcinoma

“…Hoyer et al reported the results of a Phase II study using SBRT in the treatment of locally advanced pancreatic carcinoma, in which the median survival time was only 5.7 months, with 18% of patients suffering from severe mucositis or ulceration of the stomach or duodenum [17]. Recently, there have been reports suggesting that SBRT and chemotherapy might be a useful treatment option, resulting in a median survival time of 10.6-14.3 months with acceptable complications [18][19][20]. Additional reports suggest that IORT can be used to prevent local recurrence after resection or to control abdominal pain.…”