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This guideline discusses indications for both conventionally fractionated radiation therapy and SBRT for pancreatic cancer in the adjuvant, neoadjuvant and definitive settings. It also provides recommendations on doses, target volumes, and sequencing with systemic therapies.
- Radiation Therapy for Pancreatic Cancer: An ASTRO Evidence-Based Guideline
To provide recommendations on indications, dose, target...
- Radiation Therapy for Pancreatic Cancer: An ASTRO Evidence-Based Guideline
To provide recommendations on indications, dose, target volumes, and sequencing with chemotherapy for conventionally fractionated RT and SBRT in pancreatic cancer. The guideline also considers technical aspects of RT delivery and use of prophylactic medications to mitigate toxicity.
5 wrz 2023 · Recommendations are based on available scientific data and the authors’ collective expert opinion. •. ESMO-MCBS and ESCAT scores provide levels of evidence for treatment choices, including targeted therapies. •. In clinical practice, all recommendations provided need to be discussed with patients in a shared decision-making approach. Key words.
Patients who are elderly or have a poor performance status (ECOG ≥2) are typically offered gemcitabine or gemcitabine and nab-paclitaxel prior to RT. The duration of therapy (2-6+ months) depends on how patient tolerance and tumor response (ie, no evidence of progression while on chemotherapy).
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.
Currently there are no efficient screening tools available that can be recommended outside a high risk population, e.g. those suffering from the hereditary conditions outlined above. For those, regular endoscopic ultrasound (EUS) that allows the detection of small lesions and magnetic resonance imaging (MRI) is recommended [6, 7].
5 sie 2020 · This focused update to the ASCO Metastatic Pancreatic Cancer guideline includes new evidence for targeted therapy options after first-line therapy for disease that has progressed, intolerable toxicity, or as maintenance therapy after a response.
