Mednet Logo
HomeRadiation OncologyQuestion

Do you recommend neoadjuvant chemotherapy or induction chemo + chemoRT for borderline resectable pancreatic cancer?

2
3 Answers
Mednet Member
Mednet Member
Radiation Oncology · Memorial Sloan-Kettering Cancer Center

The definition of BRPC has expanded to include everything from minimal venous involvement to 180 degree abutment of the SMA. It is important to determine if there is arterial involvement. If there is, the best data show that XRT helps with R0 resections. In our experience at MDACC, 95% of patients w...

Register or Sign In to see full answer

Mednet Member
Mednet Member
Radiation Oncology · Memorial Sloan-Kettering Cancer Center

It is true that 54Gy of XRT did not improve OS in locally advanced patients in the LAP-07 trial, but that study is not relevant to the BRPC population with arterial involvement (also T4 but resectable) where the issue is improving margin negative resectability. Margins are +80% of the time without X...

Register or Sign In to see full answer

Mednet Member
Mednet Member
Medical Oncology · Beth Israel Deaconess Medical Center

I would add the findings of Hammel et al. published in JAMA recently: patients with stage III locally advanced disease (so T4, unresectable at diagnosis) were randomized to chemo (gemcitibine, since the trial was started before FOLFIRINOX and Abraxane) vs. chemoRT (after an earlier randomization to ...

Register or Sign In to see full answer