How would you treat an isolated pancreatic adenocarcinoma recurrence in the post-op bed with progression through chemotherapy and no prior radiation therapy?

Topics: Radiation Oncology • Gastrointestinal Cancers

What dose/fractionation scheme is appropriate? Can SBRT be utilized? Can chemorRT with Xeloda be curative in this setting?

Answer from: Radiation Oncologist at Academic Institution

These tumors can usually be treated more easily with definitive doses of radiation because the duodenum has been removed. We are presenting our 69pt experience treating isolated local recurrence with ablative doses at ASTRO this year. Doses: 100Gy BED, (50Gy/5#, 67.5/15#, or 75Gy/25#). Median OS:...

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Radiation Oncologist at UTHSCSA
Do you have a constraint for the anastomosis and h...

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
Yes, same constraints. Best we can tell severe ble...

Answer from: Radiation Oncologist at Academic Institution

Palliative RT.

Answer from: Radiation Oncologist at Community Practice

I recently planned a patient a bit like that, with one important distinction - he's not progressing through chemo but has a late recurrence after adjuvant chemo. It's been 3 years since his Whipple and adjuvant chemo, but now has a gradually enlarging recurrence seen on CT during the past year that ...

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