The Evolving Role of Neoadjuvant Radiation Therapy in Pancreatic Adenocarcinoma Article Swipe
John Michael Bryant
,
Justyn Nakashima
,
Vaseem Khatri
,
Andrew J. Sinnamon
,
Jason W. Denbo
,
Pamela J. Hodul
,
Mokenge P. Malafa
,
Sarah E. Hoffe
,
Jessica M. Frakes
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.3390/jcm13226800
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.3390/jcm13226800
Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest cancers. Surgical resection is the most reliable chance for cure, but high rates of positive margins and local failure persist. Neoadjuvant therapies (NAT), including chemotherapy and radiation therapy (RT), are being explored to improve surgical outcomes, particularly in borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC). This review aims to summarize the current landscape and future directions for neoadjuvant RT (NART) in PDAC. Methods: The review includes a detailed analysis of past and ongoing clinical trials investigating various NART approaches in PDAC, with an emphasis on different RT techniques, fractionation schemes, and their integration into multimodal treatment strategies. Results: Early evidence suggests that NART can improve resection margins and local control. However, recent trials, including the Alliance A021501 and LAP-07 trials, have failed to demonstrate significant survival benefits with the addition of RT to NAT. Nevertheless, nuances in trial design and execution continue to keep the question of NART open. Newer approaches, such as stereotactic magnetic resonance-guided adaptive radiation therapy (SMART), show promise in improving local control and survival, but further phase 3 trials are needed. Conclusions: While NART has shown potential in improving local control in PDAC, its impact on overall survival remains unclear. Ongoing trials, particularly those utilizing advanced techniques like SMART, are critical in defining the role of RT in the neoadjuvant setting for PDAC. Collaboration across multidisciplinary teams is essential to optimize treatment strategies and trial outcomes.
Related Topics
Concepts
Medicine
Radiation therapy
Neoadjuvant therapy
Adenocarcinoma
Oncology
Internal medicine
Cancer
Breast cancer
Metadata
- Type
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- Language
- en
- Landing Page
- https://doi.org/10.3390/jcm13226800
- https://www.mdpi.com/2077-0383/13/22/6800/pdf?version=1731408472
- OA Status
- gold
- Cited By
- 3
- References
- 104
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4404276766
All OpenAlex metadata
Raw OpenAlex JSON
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https://openalex.org/W4404276766Canonical identifier for this work in OpenAlex
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https://doi.org/10.3390/jcm13226800Digital Object Identifier
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The Evolving Role of Neoadjuvant Radiation Therapy in Pancreatic AdenocarcinomaWork title
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reviewOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-11-12Full publication date if available
- Authors
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John Michael Bryant, Justyn Nakashima, Vaseem Khatri, Andrew J. Sinnamon, Jason W. Denbo, Pamela J. Hodul, Mokenge P. Malafa, Sarah E. Hoffe, Jessica M. FrakesList of authors in order
- Landing page
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https://doi.org/10.3390/jcm13226800Publisher landing page
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https://www.mdpi.com/2077-0383/13/22/6800/pdf?version=1731408472Direct link to full text PDF
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goldOpen access status per OpenAlex
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https://www.mdpi.com/2077-0383/13/22/6800/pdf?version=1731408472Direct OA link when available
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Medicine, Radiation therapy, Neoadjuvant therapy, Adenocarcinoma, Oncology, Internal medicine, Cancer, Breast cancerTop concepts (fields/topics) attached by OpenAlex
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3Total citation count in OpenAlex
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2025: 3Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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