Recent Advances in Combined Modality Treatment for Locally Advanced Pancreatic Cancer

Gorkem      Aksu; Binnaz      Sarper; Cuneyt      Ulutin; Hakan      Bakkal

Abstract

Pancreatic cancer is one of the most resistant cancers to conventional treatment modalities and is generally in the locally advanced or metastatic stage at the time of initial diagnosis. Approximately only 20% of patients are diagnosed as potentially resectable but 5-year survival rate is no more than 20-25% even in these resectable ones. Realizing the poor prognosis with a single-modality approach, several studies that used the combination of chemotherapy and radiotherapy with surgery are performed in order to improve local control and survival. This review evaluates the existing data and future aspects about the combined modality treatment in locally advanced pancreatic cancer regarding both the efficiency and toxicity of these combinations and novel agents.

Keywords: pancreaticoduodenectomy, chemotherapy, intraoperative radiotherapy (IORT), adenocarcinoma, neoadjuvant therapy, streptozocin, computed tomographic (CT), gemcitabine