Document Detail


Radiation therapy in operable and locally advanced pancreatic cancer.
MedLine Citation:
PMID:  20876542     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It is well established that the development of distant metastatic disease represents the dominant pattern of tumor recurrence/progression among patients with operable and locally advanced pancreatic cancer. However, the contribution of localized or locoregional tumor burden to pancreatic cancer-associated morbidity and mortality may be underappreciated, and therefore balancing competing considerations of systemic versus local disease control becomes important in therapeutic decision-making. The role of local therapies, particularly radiation therapy, has remained somewhat controversial in this disease context. Several phase II and III trials have sought to address the relative importance and role of radiation in both the localized and locally advanced settings, including the sequencing of this modality relative to systemic therapy and its optimal means of administration. However, differences and limitations in study design have produced mixed results, particularly in terms of the contribution of radiation to overall survival benefit. An emerging paradigm that makes conceptual sense and remains the subject of active investigation is to start with a defined period of systemic treatment, thus limiting radiation to the subset of patients who do not manifest with metastatic disease during initial therapy and are therefore most likely to benefit from local control.
Authors:
Andrew H Ko; Christopher H Crane
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the National Comprehensive Cancer Network : JNCCN     Volume:  8     ISSN:  1540-1405     ISO Abbreviation:  J Natl Compr Canc Netw     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-29     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101162515     Medline TA:  J Natl Compr Canc Netw     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1022-31     Citation Subset:  IM    
Affiliation:
Division of Hematology/Oncology, University of California San Francisco Comprehensive Cancer Center, San Francisco, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Clinical Trials as Topic
Combined Modality Therapy
Humans
Pancreatectomy*
Pancreatic Neoplasms / radiotherapy*,  surgery*
Radiotherapy Dosage

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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