John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Radiation therapy and pancreatic cancer: whom is it for ? Volume 17, issue 4, juillet-août 2010

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Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Service d'Oncologie Radiothérapie, Université Paris VI, Paris4 rue de la Chine, 75020 Paris

About 7200 new cases of pancreatic adenocarcinomas are diagnosised each year in France. At the time of diagnosis, an efficient carcinologic surgery will not be possible for nearly 80% of patients, in relation to loco-regional extension or metastatic dissemination. After surgical resection, the median survival of resected patients ranges from 12 to 20 months, with a high rate of relapses. Currently, the use of radiotherapy for patients with pancreatic cancer is controversial. In adjuvant setting, the standard treatment is six months of chemotherapy with gemcitabine. Chemoradiation (CRT) may improve the survival of patients with incompletely resected tumors (R1). This must be validated in a prospective trial. Neoadjuvant CRT is a promising treatment but always under evaluation. For the treatment of patients with locally advanced tumors, there is not a standard treatment. A strategy of initial chemotherapy followed by CRT for non progressive patients is under evaluation in the international randomized trial LAP07.