What is your approach to pancreatic adenocarcinoma s/p surgery with N0/R0 disease and intermediate risk factors with regard to adjuvant chemo-radiation?
Are you offering adjuvant chemoradiation after the completion of chemotherapy to patients with resected adenocarcinoma of the head of the pancreas in the setting of an R0 resection with no involved lymph nodes?
Join Mednetto vote and see how they answered.
With the presentation of RTOG 0848 at ASCO 2024, our practice has changed to offer adjuvant chemoradiation if there is no evidence of distant spread after the completion of any planned adjuvant chemotherapy. Per 0848, we are only offering radiation to patients with tumor of the pancreatic head (body and tail lesions were not included in the study) who have R0 resections with negative nodes (the subgroup who had a survival advantage).
However, several caveats are required. RTOG 0848 started accruing patients in 2009, when management of pancreatic cancer was very different than what it is now. Neoadjuvant or peri-operative chemotherapy was used less frequently, and the standard of care for chemotherapy was single-agent gemcitabine. There was ...
Join for free or sign in to see the full answer