Radiation Oncology

Pancreatic Cancer

Questions discussed in this category

What are your top takeaways in GI Cancers from ASTRO 2024?

4 Answers available

How would you manage a borderline resectable pancreatic cancer s/p induction chemo + chemo-RT who was unable to go to surgery?

Specifically, after chemo and RT to 36.0 Gy/15 fx with stable to slight progression of disease at 6 months, what (if any) regimen of reirradiation wou...

2 Answers available

When treating pancreatic body/tail lesions that result in significant dose spread to the spleen, what is your threshold to offer pneumococcal, hemophilus influenza, and meningococcal vaccines?

2 Answers available

When a patient with pancreatic cancer received neoadjuvant chemo + chemo-RT, how do you manage an in-field, post operative positive margin?

I.e. would you offer additional radiotherapy and if so, what technique and dose would you use?

3 Answers available

Do you always biopsy suspicious liver lesions if you have a biopsy from the pancreatic mass showing PDAC?

Or do you start with systemic therapy and then reassess?

3 Answers available

What is the role of adjuvant radiation in R0 node positive resected pancreatic adenocarcinoma in light of the recently presented RTOG 0848 abstract?

RTOG 0848 presented at ASCO 2024 in abstract form: Abrams et al., Journal of Clinical Oncology 2024 What pathologic factors if any would you use to m...

4 Answers available

What are your top takeaways from ASCO GI 2023?

What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice? ...

8 Answers available

Would you offer consolidative full dose chemo-RT for local residual pancreatic disease in a patient with stage IV pancreatic adenocarcinoma with excellent response after induction chemotherapy?

Would you ever consider this approach for an initially polymetastatic patient?

2 Answers available

For insurance, how do you justify medical necessity for IMRT to the pancreas in the preoperative, unresectable, and post-operative settings?

1 Answer available

In light of the recently published Alliance A021501 trial, what is your approach to incorporating SBRT for the treatment of borderline resectable pancreatic cancer?

A021501 trial: mFOLFIRINOX vs mFOLFIRINOX with hypofractionated radiation (Katz et al., PMID 35834226)

1 Answer available

How would you treat single celiac focus of adenocarcinoma of unknown primary?

Would you consider SBRT as post-chemo consolidation for a patient with a single unresectable focus of metastatic adenocarcinoma at the celiac axis?&nb...

1 Answer available

Papers discussed in this category

JAMA,

Effect of Chemoradiotherapy vs Chemotherapy on Survival in Patients With Locally Advanced Pancreatic Cancer Controlled After 4 Months of Gemcitabine With or Without Erlotinib: The LAP07 Randomized Clinical Trial.

J Clin Oncol, 2022 Jan 27

Neoadjuvant Chemoradiotherapy Versus Upfront Surgery for Resectable and Borderline Resectable Pancreatic Cancer: Long-Term Results of the Dutch Randomized PREOPANC Trial.

BMC Cancer, 2021 Mar 23

Total neoadjuvant FOLFIRINOX versus neoadjuvant gemcitabine-based chemoradiotherapy and adjuvant gemcitabine for resectable and borderline resectable pancreatic cancer (PREOPANC-2 trial): study protocol for a nationwide multicenter randomized controlled trial.

Int J Radiat Oncol Biol Phys, 2019 Jan 23

Patterns of Local Failure After Stereotactic Body Radiation Therapy and Sequential Chemotherapy as Initial Treatment for Pancreatic Cancer: Implications of Target Volume Design.

The New England journal of medicine, 2013-10-31

Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine.

N. Engl. J. Med.,

FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer.

Lancet, 2021 Jun 05

First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial.

Eur J Cancer, 2018 Aug 24

A randomised phase 2 trial of nab-paclitaxel plus gemcitabine with or without capecitabine and cisplatin in locally advanced or borderline resectable pancreatic adenocarcinoma.

NEJM Evidence, 2022 Jun 1

Durvalumab plus Gemcitabine and Cisplatin in Advanced Biliary Tract Cancer

JAMA Oncol, 2022 Apr 1

Palliative Radiation for Advanced Central Lung Tumors With Intentional Avoidance of the Esophagus (PROACTIVE): A Phase 3 Randomized Clinical Trial.

Int J Radiat Oncol Biol Phys, 2023 Mar 01

Alleviating morbidity from locally advanced breast cancer using a practical and short radiotherapy regime: Results of the HYPORT palliative studies.

Seminars in radiation oncology, 2002 Jul

Intensity-modulated radiation therapy: the inverse, the converse, and the perverse.

Int J Radiat Oncol Biol Phys, 2022 Jul 04

A Critical Review of the Role of Local Therapy for Oligometastatic Gastrointestinal Cancer.

Lancet (London, England), 2023 Dec 14

Standard-of-care systemic therapy with or without stereotactic body radiotherapy in patients with oligoprogressive breast cancer or non-small-cell lung cancer (Consolidative Use of Radiotherapy to Block [CURB] oligoprogression): an open-label, randomised, controlled, phase 2 study.

International journal of radiation oncology, biology, physics, 2011-12-01

The influence of total nodes examined, number of positive nodes, and lymph node ratio on survival after surgical resection and adjuvant chemoradiation for pancreatic cancer: a secondary analysis of RTOG 9704.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-04-10

DPC4 gene status of the primary carcinoma correlates with patterns of failure in patients with pancreatic cancer.

JAMA Oncol,

Association of Ablative Radiation Therapy With Survival Among Patients With Inoperable Pancreatic Cancer.

Annals of surgical oncology, 2022 Jan 05

Landmark Series: Importance of Pancreatic Resection Margins.

Practical radiation oncology, 2022 Feb 07

Location, Location, Location: What Should be Targeted Beyond Gross Disease for Localized Pancreatic Ductal Adenocarcinoma? Proposal of a Standardized Clinical Tumor Volume for Pancreatic Ductal Adenocarcinoma of the Head: The "Triangle Volume".

Journal of gastrointestinal oncology, 2021 Oct

Pathology reporting of margin status in locally advanced pancreatic cancer: challenges and uncertainties.

Annals of surgery, 2024 Jul 23

Impact of Positive Resection Margins on Recurrence and Survival Following Resection and Adjuvant Chemotherapy in Pancreatic Cancer: Results of the PRODIGE 24-CCTG PA-6 Randomized Controlled Trial.

Journal of clinical medicine, 2024 Apr 30

Salvage Ablative Radiotherapy for Isolated Local Recurrence of Pancreatic Adenocarcinoma following Definitive Surgery.

Radiother Oncol, 2015 Aug 04

Radiation-induced dose-dependent changes of the spleen following postoperative chemoradiotherapy for gastric cancer.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018-06-01

Late Infection-Related Mortality in Asplenic Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2024 Mar 18

Vaccination of Adults With Cancer: ASCO Guideline.

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