Do you recommend chemoradiation following neoadjuvant FOLFIRINOX for resectable pancreatic cancer?

Tough question, with lots of evolution in this area in the past few years.

The data would suggest that for borderline resectable pancreatic cancer, there is a benefit in terms of OS from preoperative treatment. For unresectable disease, the small chance of conversion into resectability is worth the attempt at neoadjuvant treatment.

For truly resectable disease, some combination of surgery and systemic treatment is beneficial. I think the question of neoadjuvant chemoradiation is less clear, and w...

The use of chemoradiation in resectable pancreatic cancer should not be considered the routine standard of care, but can be used strategically in borderline resectable tumors and tumors in which additional "space" is needed. While neoadjuvant therapy in pancreatic cancer is becoming more routine and we await the results of larger prospective studies, such as the cooperative group studies, the management of resectable and borderline resectable disease requires ongoing multidisciplinary management...

PREOPANC trial did not prove benefits, as per the recent final report. I think it may be useful in special borderline resectable situations...

Local radiotherapy has never added to survival in localized pancreatic cancer and is not without toxicities. Why, with a more effective regimen, would it be expected to add now?