From the Guidelines
Unresectable pancreatic body tumors have limited management options, with a focus on palliative care and chemotherapy.
Management Options
- Chemotherapy: is a primary treatment option for unresectable pancreatic body tumors, with the goal of improving symptoms and prolonging survival 1.
- Chemoradiation: may be considered for patients with locally advanced unresectable disease and good performance status, although the evidence is mixed 1.
- Palliative care: is essential for managing symptoms such as biliary or gastric obstruction, severe abdominal pain, and other tumor-associated manifestations 1.
- Neoadjuvant therapy: may be considered for patients with borderline resectable disease, but its role in unresectable tumors is limited 1.
Treatment Considerations
- Performance status: is a critical factor in determining treatment options, with patients having good performance status being more likely to benefit from chemotherapy and chemoradiation 1.
- Tumor biology: and responsiveness to treatment can influence treatment decisions, with patients having tumors that are responsive to chemotherapy being more likely to benefit from treatment 1.
- Clinical trials: may be considered for patients with unresectable pancreatic body tumors, as they offer the opportunity to participate in innovative treatments and contribute to the development of new therapies 1.
From the Research
Management Options for Unresectable Pancreatic Body Tumor
- The management of unresectable pancreatic body tumor involves various treatment modalities, including:
- Stereotactic body radiotherapy (SBRT) 2, 3: SBRT allows for a higher biologically equivalent dose in an abbreviated course, making it a convenient option for patients. It has been shown to improve overall survival compared to conventionally fractionated radiotherapy (CFRT) 2.
- Radiofrequency ablation (RFA) 4, 5: RFA is a minimally invasive technique that causes tumor cytoreduction through coagulative necrosis, protein denaturation, and activation of anticancer immunity. It is used for palliative treatment of unresectable pancreatic cancer.
- Other local ablative techniques 5: These include high-intensity focused ultrasound (HIFU), microwave ablation (MWA), and irreversible electroporation (IRE). Each technique has its specific advantages and disadvantages and is tailored to the individual patient and situation.
- The treatment goals for unresectable pancreatic cancer are to maintain local control, manage tumor-related morbidities, and improve quality of life 6.
- Non-operative management of patients with unresectable pancreatic adenocarcinoma is critical, and pancreaticobiliary physicians and endoscopists play a crucial role in this management 6.
- Local ablative techniques can improve the quality of life and possibly the prognosis of patients with unresectable pancreatic cancer, although more data are needed to confirm the latter aspect 5.