Topics:
Radiation Oncology • Gastrointestinal Cancers
What is your preferred palliative regimen for pancreatic cancer with pain related to celiac plexus involvement?
Do you consider palliative SBRT 25Gy in 5 fractions? I often find that these patients are in severe pain and my typical regimen is 30 Gy in 10 fractions, but I would like to hypofractionate to get them back on chemo ASAP.
Answer from: Radiation Oncologist at Academic Institution
I prefer to use 36Gy in 12 fractions, which can be given AP/PA as long as it is homogeneous. Even though the GI rad onc academic community promotes SBRT techniques for palliation, the use of an SBRT technique in this setting is unnecessary for such low doses. I only use an SBRT technique when I woul...
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Answer from: Radiation Oncologist at Academic Institution
I agree completely. In an era where insurance companies are increasingly scrutinizing what we do (and denying things), using techniques like SBRT in this context without clear evidence is only going to make it harder to get approvals for cases that do really need advanced techniques like SBRT....