The Current Role of Radiation in Pancreatic Cancer and Future Directions

Colin S Hill; Joseph M Herman

doi:10.1016/j.clcc.2023.01.002

The Current Role of Radiation in Pancreatic Cancer and Future Directions

Clin Colorectal Cancer. 2023 Mar;22(1):12-23. doi: 10.1016/j.clcc.2023.01.002. Epub 2023 Jan 31.

Authors

Colin S Hill¹, Joseph M Herman²

Affiliations

¹ Department of Radiation Oncology, Perlmutter Cancer Center, New York University Grossman School of Medicine, New York, NY. Electronic address: colin.hill@nyulangone.org.
² Radiation Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY.

PMID: 36804206
DOI: 10.1016/j.clcc.2023.01.002

Abstract

Survival outcomes for localized pancreatic adenocarcinoma remains poor. Multimodality therapeutic regimens are critical to maximizing survival outcomes for these patients, which includes the use of systemic therapy, surgery, and radiation. In this review, the evolution of radiation techniques are discussed with a focus on modern techniques such as intensity modulated radiation and stereotactic body radiation therapy. However, the current role of radiation within the most common clinical scenarios for pancreatic cancer in the neoadjuvant, definitive, and adjuvant settings continues to be highly debated. The role of radiation in these settings is reviewed in the context of historical and modern clinical studies. In addition, emerging concepts including dose-escalated radiation, magnetic resonance-guided radiation therapy, and particle therapy are discussed to promote an understanding of how such concepts may change the role of radiation in the future.

Keywords: BRPC; IMRT; LAPC; Neoadjuvant; PDAC; SBRT.

Publication types

Review

MeSH terms

Adenocarcinoma* / pathology
Humans
Neoadjuvant Therapy
Pancreatic Neoplasms* / pathology
Radiosurgery* / methods