Maximal Ablative Irradiation Because of Encasement for Patients With Locally Advanced Pancreatic Cancer

For patients with locally advanced pancreatic cancer (LAPC) with extensive arterial and venous involvement after standard chemotherapy, is ablative radiation therapy (A-RT) associated with better resectability and overall survival without undue toxicity? In this non randomized clinical trial of 48 patients with LAPC and extensive vascular involvement persistent after 3 or more months of modified fluorouracil, leucovorin, irinotecan, and oxaliplatin or gemcitabine plus nab-paclitaxel, participants who underwent A-RT had a marginally improved resection rate and improved overall survival in resected and unresected groups compared to historical control individuals with acceptable treatment-related adverse events. For LAPC with extensive vascular encasement after induction chemotherapy, A-RT did not undermine resectability or safety of surgical resection and demonstrated promising overall survival in patients who did and did not undergo resection.

Corresponding Author: Marsha Reyngold, MD, PhD, Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065 (ReyngolM@mskcc.org).

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