The Role of Radiation Therapy for Pancreatic Cancer in the Adjuvant and Neoadjuvant Settings

Surg Oncol Clin N Am. 2017 Jul;26(3):431-453. doi: 10.1016/j.soc.2017.01.012. Epub 2017 May 11.

Abstract

Pancreatic cancer is the third leading cause of cancer-related death in the United States. Although surgery remains the only curative treatment, chemotherapy and radiation therapy are frequently used. In the adjuvant setting, radiation is usually delivered with chemotherapy to eradicate residual microscopic or macroscopic disease in the resection bed. Neoadjuvant radiation therapy has become more frequently utilized. This article reviews the historical and modern literature regarding radiation therapy in the neoadjuvant and adjuvant settings, focusing on the evolution of radiation therapy techniques and clinical trials in an attempt to identify patients best suited to receiving radiation therapy.

Keywords: Adjuvant; Chemoradiation; Neoadjuvant; Pancreas cancer; Pancreatic cancer; Proton therapy; Radiation therapy; Stereotactic body radiotherapy.

Publication types

  • Review

MeSH terms

  • Carcinoma, Pancreatic Ductal / pathology
  • Carcinoma, Pancreatic Ductal / radiotherapy*
  • Carcinoma, Pancreatic Ductal / therapy
  • Chemoradiotherapy
  • Chemoradiotherapy, Adjuvant
  • Chemotherapy, Adjuvant
  • Humans
  • Neoadjuvant Therapy / methods*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / radiotherapy*
  • Pancreatic Neoplasms / therapy
  • Radiotherapy, Adjuvant
  • Treatment Outcome