TY - JOUR
T1 - Ablative Radiotherapy (ART) for Locally Advanced Pancreatic Cancer (LAPC): Toward a New Paradigm?
AU - Simoni, Nicola
AU - Rossi, Gabriella
AU - Cellini, Francesco
AU - Vitolo, Viviana
AU - Orlandi, Ester
AU - Valentini, Vincenzo
AU - Mazzarotto, Renzo
AU - Sverzellati, Nicola
AU - D’Abbiero, Nunziata
PY - 2022
Y1 - 2022
N2 - Locally advanced pancreatic cancer (LAPC) represents a major urgency in oncology. Due to the massive involvement of the peripancreatic vessels, a curative-intent surgery is generally precluded. Historically, LAPC has been an indication for palliative systemic therapy. In recent years, with the introduction of intensive multi-agent chemotherapy regimens and aggressive surgical approaches, the survival of LAPC patients has significantly improved. In this complex and rapidly evolving scenario, the role of radiotherapy is still debated. The use of standard-dose conventional fractionated radiotherapy in LAPC has led to unsatisfactory oncological outcomes. However, technological advances in radiation therapy over recent years have definitively changed this paradigm. The use of ablative doses of radiotherapy, in association with image-guidance, respiratory organ-motion management, and adaptive protocols, has led to unprecedented results in terms of local control and survival. In this overview, principles, clinical applications, and current pitfalls of ablative radiotherapy (ART) as an emerging treatment option for LAPC are discussed.
AB - Locally advanced pancreatic cancer (LAPC) represents a major urgency in oncology. Due to the massive involvement of the peripancreatic vessels, a curative-intent surgery is generally precluded. Historically, LAPC has been an indication for palliative systemic therapy. In recent years, with the introduction of intensive multi-agent chemotherapy regimens and aggressive surgical approaches, the survival of LAPC patients has significantly improved. In this complex and rapidly evolving scenario, the role of radiotherapy is still debated. The use of standard-dose conventional fractionated radiotherapy in LAPC has led to unsatisfactory oncological outcomes. However, technological advances in radiation therapy over recent years have definitively changed this paradigm. The use of ablative doses of radiotherapy, in association with image-guidance, respiratory organ-motion management, and adaptive protocols, has led to unprecedented results in terms of local control and survival. In this overview, principles, clinical applications, and current pitfalls of ablative radiotherapy (ART) as an emerging treatment option for LAPC are discussed.
KW - ablative radiotherapy
KW - intensive chemotherapy
KW - locally advanced
KW - pancreatic cancer
KW - ablative radiotherapy
KW - intensive chemotherapy
KW - locally advanced
KW - pancreatic cancer
UR - http://hdl.handle.net/10807/203359
U2 - 10.3390/life12040465
DO - 10.3390/life12040465
M3 - Article
SN - 2075-1729
VL - 12
SP - N/A-N/A
JO - Life
JF - Life
ER -