title: [Radiation therapy of pancreatic cancer].
abstract: Currently, the use of radiation therapy for patients with pancreatic cancer is subject to discussion. In adjuvant setting, the standard treatment is 6 months of chemotherapy with gemcitabine and capecitabine. Chemoradiation (CRT) may improve the survival of patients with incompletely resected tumors (R1). This should be confirmed by a prospective trial. Neoadjuvant CRT is a promising treatment especially for patients with borderline resectable tumors. For patients with locally advanced tumors, there is no a standard. An induction chemotherapy followed by CRT for non-progressive patients reduces the rate of local relapse. Whereas in the first trials of CRT large fields were used, the treated volumes have been reduced to improve tolerance. Tumor movements induced by breathing should be taken in account. Intensity modulated radiation therapy allows a reduction of doses to the organs at risk. Whereas widely used, this technique is not recommended.
authors: Service d'oncologie radiothérapie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France. Electronic address: florence.huguet@aphp.fr.
authors: F
authors: F
authors: Huguet
authors: Département d'oncologie radiothérapie, centre hospitalier Lyon Sud, 69000 Pierre-Bénite, France; EMR 3738, université Claude-Bernard Lyon 1, 69000 Lyon, France.
authors: F
authors: F
authors: Mornex
authors: Unité de radiophysique, service de radiothérapie, hôpital Tenon, AP-HP, 75020 Paris, France.
authors: A
authors: A
authors: Orthuon
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000069287:Capecitabine / Q000008:administration & dosage; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D019583:Dose Fractionation, Radiation; D006801:Humans; D020360:Neoadjuvant Therapy; D058958:Organs at Risk; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D011832:Radiation Injuries / Q000517:prevention & control; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods / Q000592:standards; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant / Q000379:methods; D061089:Radiotherapy, Image-Guided / Q000379:methods; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D000069287:Capecitabine; D000093542:Gemcitabine
keywords: 4D; Borderline; Cancer du pancréas; Conformal radiotherapy; IMRT; Pancreatic cancer; RCMI; Radiothérapie conformationnelle; Target volumes; Volumes cibles