Do you escalate the dose in adjuvant pancreatic cancer radiation therapy similar to how many are treating locally advanced disease with dose escalation?

In the adjuvant setting, what boost dose to vascular areas can be safely applied, assuming one has all the tech to reliably breath hold the patient and meets the standard bowel dose constraints used in RTOG 0848 (including care to avoid the jejunostomies from the high dose boost)?

Do you treat to a BED of 70 Gy or higher, e.g. 58-75 Gy in 25-28 fractions?

Answer from: Radiation Oncologist at Academic Institution

A few points to consider about this modern perspective on adjuvant CXRT for pancreatic cancer are: A positive margin is one of the least controversial indications for adjuvant CXRT in pancreatic cancer. If you get a case to treat, you don't want dose to be the reason for failure. 50.4Gy has been ...

Comments

Radiation Oncologist at National Cancer Institute
Other than the small 1985 GITSG trial, is there an...

Radiation Oncologist at Toledo Clinic Inc.
Interesting comment.

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
The data are very limited to be sure, but a meta-a...

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Do you escalate the dose in adjuvant pancreatic cancer radiation therapy similar to how many are treating locally advanced disease with dose escalation?

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