title: Treatment Approaches to Locally Advanced Pancreatic Adenocarcinoma.
abstract: This article focuses on the management of locally advanced pancreatic cancer, which should be treated as a distinct entity separate from metastatic disease and borderline resectable disease. Although the role, timing, and sequencing of radiation relative to systemic therapy in this disease are controversial, an emerging treatment paradigm involves induction chemotherapy, followed by consolidative chemoradiation in patients who do not progress. In addition, new chemotherapy regimens as well as novel radiosensitizers have shown promise and need to be tested further in the locally advanced setting. Advances in radiotherapy have enabled stereotactic body radiotherapy and should continue to be prospectively evaluated.
authors.affiliation: Department of Radiation Oncology, Stanford Cancer Center, Stanford University, 875 Blake Wilbur Drive, MC5847, Stanford, CA 94305-5847, USA.
authors.forename: Erqi L
authors.initials: EL
authors.lastname: Pollom
authors.affiliation: Department of Radiation Oncology, Stanford Cancer Center, Stanford University, 875 Blake Wilbur Drive, MC5847, Stanford, CA 94305-5847, USA.
authors.forename: Albert C
authors.initials: AC
authors.lastname: Koong
authors.affiliation: Division of Hematology/Oncology, University of California San Francisco, 1600 Divisadero Street, 4th Floor, Box 1705, San Francisco, CA 94115, USA. Electronic address: andrewko@medicine.ucsf.edu.
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Ko
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods*; D017326:Clinical Trials, Phase III as Topic; D060830:Consolidation Chemotherapy / Q000379:methods*; D018572:Disease-Free Survival; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods*; D060046:Maintenance Chemotherapy / Q000379:methods*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic
chemical_list: D011838:Radiation-Sensitizing Agents
keywords: Combined-modality therapy; Induction; Locally advanced; Pancreatic cancer; Stereotactic body radiation