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Published on: June 6, 2020
Optimizing neoadjuvant chemoradiation in resectable and borderline resectable pancreatic cancer: Evidence-based
Gautam Sarma1, Hima Bora2, Partha P Medhi1
1Department of Radiation Oncology, All India Institute of Medical Sciences, Guwahati 781101, Assam, India.
Abstract:
Since its inception, localized pancreatic cancer has been identified as a systemic illness. Hence, to increase its survival rates, surgical resection followed by adjuvant chemotherapy is used as a treatment option. A significant barrier, though, is the high morbidity and drawn-out recovery after extensive surgical resection, which may postpone or prohibit the prompt administration of adjuvant therapy. Thereby, acknowledging the efficacy of neoadjuvant therapy in various digestive tract malignancies like rectal, gastric, and oesophagal cancers in enhancing long-term survival and the likelihood of successful resection, researchers have turned their attention to exploring its potential benefits in the context of both resectable and borderline resectable pancreatic cancer (RPC). According to recent data, neoadjuvant chemoradiation has major advantages for both resectable and borderline RPC. These advantages include increased surgical resection rates, longer survival times, decreased recurrence rates, and better overall disease control with a manageable toxicity profile. Despite its benefits, research is still being done to determine the best way to sequence and combine chemotherapy and radiation. Furthermore, studies have demonstrated the potential for customized therapy regimens based on the patient's general health status and the tumor's biological behavior to maximize the neoadjuvant approach. As progress continues, neoadjuvant chemoradiation is set to become a key component of treatment for both resectable and borderline RPC, providing a more efficient way to manage this deadly condition. While further development is required to fully grasp its potential in enhancing long-term patient outcomes, evidence supports its increasing usage in clinical practice.
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