In a patient with borderline resectable pancreatic adenocarcinoma s/p 10 cycles FOLFOX and aborted Whipple due to locally advanced disease, do you recommend dose escalation beyond 54 Gy?

Patient with a 3 cm tumor invading the SMV/portal confluence and the first jejunal branch of SMV with subtle hazy SMA involvement. Should dose escalation be attempted where safe in the event the patient is still unresectable following radiation?

Answer from: Radiation Oncologist at Academic Institution

Yes, there is no contraindication to giving an ablative dose after exploration. 54 Gray is a palliative dose, which has not improved overall survival based on the LAP07 trial. While it's fair to say that we do not know the definition of definitive or ablative in LAPC, we have published OS results ve...

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Radiation Oncologist at University of Arizona Cancer Center
Thank you for your invaluable input, Dr. @Crane. I...

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In a patient with borderline resectable pancreatic adenocarcinoma s/p 10 cycles FOLFOX and aborted Whipple due to locally advanced disease, do you recommend dose escalation beyond 54 Gy?

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