Radiation Therapy For Pancreatic Cancer

Following surgical resection of pancreatic cancer, adjuvant conventionally fractionated RT with chemotherapy in select high-risk patients is conditionally recommended. (Conditional (weak), Low)

Following surgical resection of pancreatic cancer, adjuvant SBRT is only recommended on a clinical trial or multi-institutional registry. (Strong, Very low)

For patients with resectable pancreatic cancer, neoadjuvant therapy is conditionally recommended. (Conditional (weak), Low)

For patients with borderline resectable pancreatic cancer and select locally advanced pancreatic cancer appropriate for downstaging prior to surgery, a neoadjuvant therapy regimen of systemic chemotherapy followed by conventionally fractionated RT with chemotherapy is conditionally recommended. (Conditional (weak), Moderate)

For patients with borderline resectable pancreatic cancer and select locally advanced pancreatic cancer appropriate for downstaging prior to surgery, a neoadjuvant therapy regimen of systemic chemotherapy followed by multifraction SBRT is conditionally recommended. (Conditional (weak), Low)

For patients with locally advanced pancreatic cancer not appropriate for downstaging to eventual surgery, a definitive therapy regimen of systemic chemotherapy followed by either (1) conventionally fractionated RT with chemotherapy, (2) dose-escalated chemoradiation, or (3) multifraction SBRT without chemotherapy is conditionally recommended. (Conditional (weak), Low)