tailieunhanh - Báo cáo khoa học: " The role of radiotherapy in multimodal treatment of pancreatic carcinoma"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Radiation Oncology cung cấp cho các bạn kiến thức về ngành y đề tài: The role of radiotherapy in multimodal treatment of pancreatic carcinoma. | Brunner and Scott-Brown Radiation Oncology 2010 5 64 http content 5 1 64 RADIATION ONCOLOGY REVIEW Open Access The role of radiotherapy in multimodal treatment of pancreatic carcinoma Thomas B Brunner and Martin Scott-Brown Abstract Pancreatic ductal carcinoma is one of the most lethal malignancies but in recent years a number of positive developments have occurred in the management of pancreatic carcinoma. This article aims to give an overview of the current knowledge regarding the role of radiotherapy in the treatment of pancreatic ductal adenocarcinoma PDAC . The results of meta-analyses phase III-studies and phase II-studies using chemoradiotherapy and chemotherapy for resectable and non-resectable PDAC were reviewed. The use of radiotherapy is discussed in the neoadjuvant and adjuvant settings as well as in the locally advanced situation. Whenever possible radiotherapy should be performed as simultaneous chemoradiotherapy. Patients with PDAC should be offered entry into clinical trials to identify optimal treatment results. Introduction Despite considerable progress in oncology the poor prognosis of patients with pancreatic ductal adenocarcinoma PDAC has not significantly improved. In Europe and the USA PDAC is still ranked fourth and in the UK sixth for cancer associated mortality 1 2 . More than 80 of patients with PDAC present with irresectable disease. One third of these patients have locally advanced pancreatic carcinoma LAPC the rest have distant metastases. In this article we review the role of radiotherapy RT currently used as chemoradiotherapy CRT in the management of pancreatic cancer. We discuss its neoadjuvant use in improving resectability rates its adjuvant use in maintaining local control and its role as primary treatment of LAPC. To identify eligible studies we undertook a Medline database search from 1980 to 2008 and also included unpublished meeting reports of phase III trials. Wherever possible we focused on the data .