Neoadjuvant chemoradiation for adenocarcinoma of the pancreas.

T. M. Breslin*, N. A. Janjan, J. E. Lee, P. W. Pisters, R. A. Wolff, J. L. Abbruzzese, D. B. Evans

*Corresponding author for this work

Research output: Contribution to journalReview article

18 Scopus citations

Abstract

Adjuvant 5-fluorouracil and concurrent radiation may improve survival following complete surgical resection in patients with pancreatic adenocarcinoma. However, the morbidity and prolonged recovery associated with pancreaticoduodenectomy frequently prevents the timely delivery of postoperative chemoradiation. Therefore, the University of Texas M.D. Anderson Cancer Center (MDACC) has investigated the use of neoadjuvant chemoradiation in potentially resectable pancreatic cancer. We have incorporated a standardized approach to pretreatment staging, operative technique and pathologic evaluation. Our initial experience suggests that preoperative chemoradiation is well tolerated and may reduce loco-regional recurrence. Patients treated with rapid-fractionation preoperative chemoradiation had a significantly shorter duration of treatment compared with patients who received postoperative chemoradiation or standard-fractionation preoperative chemoradiation. New and more potent radiation-sensitizing agents such as gemcitabine may further enhance local control. Novel therapies directed at specific molecular events involved in pancreatic tumorigenesis may be incorporated into preoperative and postoperative regimens to attempt to reduce systemic relapse.

Original languageEnglish (US)
Pages (from-to)E193-203
JournalFrontiers in bioscience : a journal and virtual library
Volume3
StatePublished - Nov 1 1998

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

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    Breslin, T. M., Janjan, N. A., Lee, J. E., Pisters, P. W., Wolff, R. A., Abbruzzese, J. L., & Evans, D. B. (1998). Neoadjuvant chemoradiation for adenocarcinoma of the pancreas. Frontiers in bioscience : a journal and virtual library, 3, E193-203.