Radiation therapy for pancreatic cancer: Executive summary of an ASTRO Clinical Practice Guideline Journal Article


Authors: Palta, M.; Godfrey, D.; Goodman, K. A.; Hoffe, S.; Dawson, L. A.; Dessert, D.; Hall, W. A.; Herman, J. M.; Khorana, A. A.; Merchant, N.; Parekh, A.; Patton, C.; Pepek, J. M.; Salama, J. K.; Tuli, R.; Koong, A. C.
Article Title: Radiation therapy for pancreatic cancer: Executive summary of an ASTRO Clinical Practice Guideline
Abstract: Purpose: This guideline systematically reviews the evidence for treatment of pancreatic cancer with radiation in the adjuvant, neoadjuvant, definitive, and palliative settings and provides recommendations on indications and technical considerations. Methods and Materials: The American Society for Radiation Oncology convened a task force to address 7 key questions focused on radiation therapy, including dose fractionation and treatment volumes, simulation and treatment planning, and prevention of radiation-associated toxicities. Recommendations were based on a systematic literature review and created using a predefined consensus-building methodology and system for grading evidence quality and recommendation strength. Results: The guideline conditionally recommends conventionally fractionated or stereotactic body radiation for neoadjuvant and definitive therapy in certain patients and conventionally fractionated regimens for adjuvant therapy. The task force suggests a range of appropriate dose-fractionation schemes and provides recommendations on target volumes and sequencing of radiation and chemotherapy. Motion management, daily image guidance, use of contrast, and treatment with modulated techniques are all recommended. The task force supported prophylactic antiemetic medication, and patients may also benefit from medications to reduce acid secretion. Conclusions: The role of radiation in the management of pancreatic cancer is evolving, with many ongoing areas of active investigation. Radiation therapy is likely to become even more important as new systemic therapies are developed and there is increased focus on controlling local disease. It is important that the nuances of available data are discussed with patients and families and that care be coordinated in a multidisciplinary fashion. © 2019 American Society for Radiation Oncology
Journal Title: Practical Radiation Oncology
Volume: 9
Issue: 5
ISSN: 1879-8500
Publisher: Elsevier Inc.  
Date Published: 2019-09-01
Start Page: 322
End Page: 332
Language: English
DOI: 10.1016/j.prro.2019.06.016
PROVIDER: scopus
PUBMED: 31474330
DOI/URL:
Notes: Article -- Export Date: 4 September 2019 -- Source: Scopus
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  1. Richard Tuli
    4 Tuli