For borderline resectable pancreas treated with induction chemo therapy and minimal radiographic response, if unable to do SBRT, do you prefer 36/15 or 50.4/28 (given that is where we have more data)?

The concern being that if patient does not go to surgery, you have delivered lower BED with 36/15.

Answer from: Radiation Oncologist at Academic Institution

Low dose small-volume SBRT should not be used in the preoperative setting for pancreatic cancer. It was never a good idea to begin with. Due to very tight margins of 2-5 mm on the GTV, it has resulted in 30-50% marginal miss resulting in local recurrences outside of the treated volume now reported i...

Comments

Radiation Oncologist at Radiant Oncology
Thank you! How long after completion do you typica...

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
Five or six weeks.

Radiation Oncologist at Multicare Radiation Therapy
Very helpful. Can you please provide references to...

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
Cloyd JM et al., Impact of hypofractionated and st...

Radiation Oncologist at START Center for Cancer Care
Is your preference still to use 67.5 Gy in 15 frac...

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
If surgery is planned, we give 36 Gy in 12 fractio...

Radiation Oncologist at START Center for Cancer Care
I really appreciate the work you are doing. Electi...

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
I would rather not comment because the numbers are...

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For borderline resectable pancreas treated with induction chemo therapy and minimal radiographic response, if unable to do SBRT, do you prefer 36/15 or 50.4/28 (given that is where we have more data)?

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