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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 make your recommendation?
Previous version of question: Would you recommend adjuvant chemoradiation after adjuvant chemotherapy for a patient with pancreatic adenocarcinoma s/p Whipple resection with negative margins?
Answer from: Radiation Oncologist at Academic Institution
There is no role/evidence of a survival benefit in RTOG 0848 or any other randomized trial for patients with R0 / N+. It is an open question whether local control would be important enough to improve survival in the context of adjuvant FOLFIRINOX.
Answer from: Radiation Oncologist at Academic Institution
In light of the recent RTOG 0848 results, there is a case to be made for offering adjuvant CRT, particularly with node-negative disease.
Answer from: Medical Oncologist at Academic Institution
I’m a bit unclear after reading the abstract and think it might be helpful to see the final manuscript. Do patients with node negative disease do better because the node positive patients die from metastatic disease? Are all node negative patients the same? Would also like to see the chemother...
Comments
Radiation Oncologist at Washington University School of Medicine
I would like to know how the R1 resections were di...
I would like to know how the R1 resections were di...
Have you published your data on treating patients ...
Not yet, we will submit it to ASTRO this year.
*those cases were from MSK, all treated in the las...
Would a patient with negative margins post-whipple...
I would watch and wait. There is no clear OS benef...