What dose/fractionation would you choose for resected tail of pancreas adeno with positive margin, node negative?

Topics: Radiation Oncology • Gastrointestinal Cancers • Liver and Pancreas Tumors

Plan to give adjuvant chemotherapy.

Answer from: Radiation Oncologist at Academic Institution

62.5 Gy in 25 fx to the margin if R1. If R2, 75 Gy in 25 fx with motion management. Regional nodes get 45 Gy in 25 fx. Max point dose to the stomach and jejunum 60 Gy.

Comments

Radiation Oncologist at Mallory Radiotherapy, PLLC
Do you still favor chemoRT in this manner over adj...

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
Sorry, if I was not clear. I did not mean to sugge...

Answer from: Radiation Oncologist at Academic Institution

If bowel is favorable to achieving typical constraints, 5 fraction SBRT is an option (since there are no anastomoses with a typical distal pancreatectomy). Can treat 40-50 Gy/5 fraction to +margin (pancreatic resection margin + at least 1cm for CTV high) with ENI 25/5. Breath hold; triggered imaging...

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