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

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: 26...

Palliative RT.

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 ...