How do you treat unresectable pancreatic adenocarcinoma invading into the duodenum?

Topics: Radiation Oncology • Gastrointestinal Cancers

Would you consider "neoadjuvant" RT to 45-50.4 Gy followed by a resimulation and a boost to a "definitive" dose of 54+ Gy depending upon disease response?

Answer from: Radiation Oncologist at Academic Institution

No, 54Gy did not improve survival in the LAP-07 trial, so it is definitively not a definitive dose. I would give 75Gy in 25 fx (100Gy BED) with capectabine. We have published how we do this in multiple papers, but essentially a 5mm duodenal PRV is carved out of the PTV75 so that there is a gr...

Comments

Radiation Oncologist at University of Sao Paulo
Thank you for the answer, Dr. Crane. Could you sha...

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
Of course Gabriel, Duodenum and stomach based on ...

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
Correction: Kelly et al, IJROBP, 2012

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