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Review
. 2018 Dec 13:7:F1000 Faculty Rev-1931.
doi: 10.12688/f1000research.16272.1. eCollection 2018.

Recent advances in radiation therapy of pancreatic cancer

Bhanu Prasad Venkatesulu  1 , Cheng-En Hsieh  1   2   3   4 , Keith L Sanders  1 , Sunil Krishnan  1   2   3
Affiliations
Review

Recent advances in radiation therapy of pancreatic cancer

Bhanu Prasad Venkatesulu et al. F1000Res. .

Abstract

Pancreatic cancer has a dismal prognosis with an overall survival outcome of just 5% at five years. However, paralleling our improved understanding of the biology of pancreatic cancer, treatment paradigms have also continued to evolve with newer advances in surgical techniques, chemotherapeutic agents, radiation therapy (RT) techniques, and immunotherapy paradigms. RT dose, modality, fraction size, and sequencing are being evaluated actively, and the interplay between RT and immune effects has opened up newer avenues of research. In this review, we will emphasize recent advances in RT for pancreatic cancer, focusing on preoperative chemoradiation, RT dose escalation, sparing of the spleen to reduce lymphopenia, and combination of RT with immunotherapy.

Keywords: Dose escalation; immunotherapy; neoadjuvant therapy; radiotherapy; spleen sparing.

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Conflict of interest statement

No competing interests were disclosed.No competing interests were disclosed.No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. Representative images and treatment plan for dose-escalated radiation therapy for pancreatic cancer.
Axial ( a), sagittal ( b), and coronal ( c) view of a patient who received 50.4 Gy in 28 fractions to the planning target volume with simultaneous integrated boost of 55 Gy to the clinical target volume and 70 Gy boost to the gross tumor volume. ( d) Dose volume histogram of the targets and organs at risk. This figure was produced by SK, ( a), ( b) and ( c) uses original images taken in SK’s clinic for this publication.
See this image and copyright information in PMC

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