Abstract
Borderline resectable pancreatic cancer (BRPC) requires multimodal therapy in order to obtain best treatment outcomes. While surgical resection remains the only cure, this is often not achievable at time of presentation. Neoadjuvant chemotherapy and radiation therapy are therefore often considered as first-line therapy to decrease tumor burden and increase the chances at an R0 section. Many different treatment strategies exist; however, FOLFIRINOX-based chemotherapy remains the gold standard. In addition, radiation therapy can be considered; however, there are no current standard radiotherapy regimens for the treatment of BRPC.
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References
Clinical practice guidelines in oncology. In: Pancreatic adenocarcinoma. National Comprehensive Cancer Network. 2016. http://www.nccn.org/progessional/physician_gls/pdf/pancreatic. Accessed 1 Apr 2016.
Wong JC, Lu DS. Staging of pancreatic adenocarcinoma by imaging studies. Clin Gastroenterol Hepatol. 2008; 6:1301–1308. doi: 10.10/j.cgh.2008.09.014
Katz MH, Crane CH, Varadhacery G. Management of borderline resectable pancreatic cancer. Semin Radiat Oncol. 2014;24:105–12. doi:10.1016/j.semradonc.2013:11.006.
DeRosa A, Cameron IC, Gomez D. Indications for staging laparoscopy in pancreatic cancer. HPB. 2016;18:13–20. doi:10.1016/j.hpb.2015.10.004.
Ritts RE, Pitt HA. CA 19-9 in pancreatic cancer. Surg Oncol Clin N Am. 1998;7:93–101.
Mann DV, Edwards R, Ho S, Lau WY, Glazer G. Elevated tumour marker CA19-9: clinical interpretation and influence of obstructive jaundice. Eur J Surg Oncol. 2000;26:474–9.
Schwarz L, Katz MH. Diagnosis and management of borderline resectable pancreatic adenocarcinoma. Hematol Oncol Clin N Am. 2015;29:727–40. doi:10.1016/j.hoc.2015.04.004.
Sohn TA, Yeo CJ, Cameron JL, et al. Resected adenocarcinoma of the pancreas-616 patients: results, outcomes, and prognostic indicators. J Gastrointest Surg. 2000;4:567–79.
Verma V, Li J, Lin C. Neoadjuvant therapy for pancreatic cancer: A systematic review of postoperative morbidity, mortality and complications. Am J Clin Oncol. 2016;39(3):302–13. doi:10.1097/COC. 0000000000000278.
Cho SW, Tzeng CW, Johnston WC, Cassera MA, et al. Neoadjuvant radiation therapy and its impact on complications after pancreaticoduodenectomy for pancreatic cancer: analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). HPB. 2014;16(4):350–6.
Papavasiliou P, Hoffman JP, Cohen SJ, et al. Impact of preoperative therapy on patterns of recurrence in pancreatic cancer. HPB. 2014;16(1):34–9. doi:10.1111/hpb.12058.
Hishinuma S, Ogata Y, Tomikawa M, et al. Patterns of recurrence after curative resection of pancreatic cancer, based on autopsy results. J Gastrointest Surg. 2006;10:511–8.
Greer SE, Pipas JM, Sutton JE, et al. Effect of neoadjuvant therapy on local recurrence rates after resection of pancreatic adenocarcinoma. J Am Coll Surg. 2008;206:451–7. doi:10.1016/j.jamcollsurg.2007.10.002.
Abrams RA, Lowy AM, O’Reilly EM, et al. Combined modality treatment of resectable and borderline resectable pancreas cancer: expert consensus statement. Ann Surg Oncol. 2009;16:1751–6. doi:10.1245/s10434-009-0413-9.
Conroy T, Desseigne G, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;364(19):1817–25. doi:10.1056/NEJMoa1011923.
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Hill, M.V., Smith, K.D. (2017). Neoadjuvant Multimodality Therapy for Borderline Resectable Pancreatic Head Cancer. In: Gardner, T., Smith, K. (eds) Pancreatology. Springer, Cham. https://doi.org/10.1007/978-3-319-53091-8_15
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DOI: https://doi.org/10.1007/978-3-319-53091-8_15
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