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Neoadjuvant vs Adjuvant Therapy for Resectable Pancreatic Cancer: The Evolving Role of Radiation

Hoffe, Sarah, MD ; Rao, Nikhil, MD ; Shridhar, Ravi, MD, PhD

Seminars in radiation oncology, 2014-04, Vol.24 (2), p.113-125 [Periódico revisado por pares]

United States: Elsevier Inc

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  • Título:
    Neoadjuvant vs Adjuvant Therapy for Resectable Pancreatic Cancer: The Evolving Role of Radiation
  • Autor: Hoffe, Sarah, MD ; Rao, Nikhil, MD ; Shridhar, Ravi, MD, PhD
  • Assuntos: Chemotherapy, Adjuvant - methods ; Hematology, Oncology and Palliative Medicine ; Humans ; Neoadjuvant Therapy - methods ; Pancreatic Neoplasms - drug therapy ; Pancreatic Neoplasms - radiotherapy ; Pancreatic Neoplasms - surgery ; Radiology ; Radiotherapy, Adjuvant - methods ; Treatment Outcome
  • É parte de: Seminars in radiation oncology, 2014-04, Vol.24 (2), p.113-125
  • Notas: ObjectType-Article-2
    SourceType-Scholarly Journals-1
    ObjectType-Feature-3
    content type line 23
    ObjectType-Review-1
  • Descrição: A major challenge with pancreatic cancer management is in the discrimination of clearly resectable tumors from those that would likely be accompanied by a positive resection margin if upfront surgery was attempted. The standard of care for clearly resectable pancreatic cancer remains surgery followed by adjuvant therapy, but there is considerable controversy over whether such therapeutic adjuvant strategies should include radiotherapy. Furthermore, in a malignancy with such high rates of distant metastasis, investigators are now exploring the feasibility and outcomes of delivering therapy in the neoadjuvant setting, both for clearly resectable as well as borderline resectable tumors. In this review, we explore the current standard of care of upfront surgery for clearly resectable cancers followed by adjuvant therapy, focusing on the role of radiotherapy. We highlight the difficulties in interpreting a literature fraught with inconsistencies in how resectable vs borderline resectable cancers are defined and treated. Finally, we explore the role of neoadjuvant strategies in the modern era.
  • Editor: United States: Elsevier Inc
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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