[Chemoradiotherapy for Locally Advanced Pancreatic Cancer]

The use of FOLFIRINOX and gemcitabine plus nab-paclitaxel for unresectable pancreatic cancer is currently approved in Japan. Although the efficacies of these regimens were investigated only in patients with metastatic pancreatic cancer, they are also expected to be effective for locally advanced pancreatic cancer. Meanwhile, chemoradiotherapy is recognized as a treatment option for locally advanced pancreatic cancer. S-1 or capecitabine-based chemoradiotherapy is being developed in Japan or in Western countries, respectively. Recently, the concept of induction chemotherapy followed by chemoradiotherapy has been accepted and applied in clinical trials. In the JCOG1106 trial, induction gemcitabine followed by S-1 and concurrent radiotherapy demonstrated promising results. This regimen has been recognized as a very promising one for chemoradiotherapy in Japan. However, the optimal therapy for locally advanced pancreatic cancer remains controversial, especially in terms of which between chemotherapy and chemoradiotherapy is superior.