[Is there still a place for radiotherapy for the treatment of pancreatic cancers?]

Abstract

About 7,200 new cases of pancreatic adenocarcinoma are diagnosed each year in France. At the time of diagnosis, only 20% of patients have an operable tumor; 30% have local or regional extensions and 50% metastatic dissemination. Median survival of patients after surgical resection ranges from 12 to 20 months, because of the high relapse rate. Currently, the use of radiotherapy is controversial for patients with operable or locally advanced pancreatic cancer. The standard treatment is six months of chemotherapy with FUFOL or gemcitabine. Combining it with radiation therapy as an adjuvant (CRT) may improve the survival of patients with incompletely resected tumors. This must still be demonstrated in a prospective trial. Neoadjuvant CRT is a promising treatment but still under evaluation. There is no standard treatment for patients with locally advanced tumors. A strategy of initial chemotherapy (gemcitabine) followed by CRT for patients with non-progressive tumors is under evaluation in the LAP07randomized trial.