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Pancreatic Cancer: Background and Clinical Evidence

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References

  1. Howlader N, Noone A, Krapcho M, et al. SEER cancer statistics review, 1975–2012, national cancer institute. http://seer.cancer.gov/statfacts/html/pancreas.html. Updated based on November 2014 SEER data submission, posted to the SEER web site, April 2015. Accessed 1 March 2016.

  2. Rahib L, Smith BD, Aizenberg R, Rosenzweig AB, Fleshman JM, Matrisian LM. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the united states. Cancer Res. 2014;74(11):2913–21.

    Article  CAS  PubMed  Google Scholar 

  3. Pancreatic Cancer Action Network. Pancreatic cancer facts 2016. https://www.pancan.org/wp-content/uploads/2016/02/2016-GAA-PC-Facts.pdf. Updated 2016. Accessed August 3, 2016.

  4. Malvezzi M, Carioli G, Bertuccio P, et al. European cancer mortality predictions for the year 2016 with focus on leukaemias. Ann Oncol. 2016;27(4):725–31.

    Article  CAS  PubMed  Google Scholar 

  5. Raju RS, Coburn N, Liu N, et al. A population-based study of the epidemiology of pancreatic cancer: a brief report. Curr Oncol. 2015;22(6):e478–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Antwi SO, Oberg AL, Shivappa N, et al. Pancreatic cancer: associations of inflammatory potential of diet, cigarette smoking, and long-standing diabetes. Carcinogenesis. 2016;37(5):481–90.

    Article  CAS  PubMed  Google Scholar 

  7. Holter S, Borgida A, Dodd A, et al. Germline BRCA mutations in a large clinic-based cohort of patients with pancreatic adenocarcinoma. J Clin Oncol. 2015;33(28):3124–9.

    Article  CAS  PubMed  Google Scholar 

  8. Edge S, Byrd D, Compton C, Fritz A, Greene F, Trotti A. AJCC cancer staging manual. 7th ed. New York: Springer; 2010.

    Google Scholar 

  9. 3rd Valero V, Saunders TJ, He J, et al. Reliable detection of somatic mutations in fine needle aspirates of pancreatic cancer with next-generation sequencing: implications for surgical management. Ann Surg. 2016;263(1):153–61.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Pawlik TM, Laheru D, Hruban RH, et al. Evaluating the impact of a single-day multidisciplinary clinic on the management of pancreatic cancer. Ann Surg Oncol. 2008;15(8):2081–8.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Chang DK, Johns AL, Merrett ND, et al. Margin clearance and outcome in resected pancreatic cancer. J Clin Oncol. 2009;27(17):2855–62.

    Article  PubMed  Google Scholar 

  12. Malleo G, Maggino L, Capelli P, et al. Reappraisal of nodal staging and study of lymph node station involvement in pancreaticoduodenectomy with the standard international study group of pancreatic surgery definition of lymphadenectomy for cancer. J Am Coll Surg. 2015;221(2):367–79.e4.

    Article  PubMed  Google Scholar 

  13. Lim JE, Chien MW, Earle CC. Prognostic factors following curative resection for pancreatic adenocarcinoma: a population-based, linked database analysis of 396 patients. Ann Surg. 2003;237(1):74–85.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Pantalone D, Ragionieri I, Nesi G. Improved survival in small pancreatic cancer. Dig Surg. 2001;18(1):41–6.

    Article  CAS  PubMed  Google Scholar 

  15. Pongprasobchai S, Pannala R, Smyrk TC, et al. Long-term survival and prognostic indicators in small. Pancreatology. 2008;8(6):587–92.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Haas M, Heinemann V, Kullmann F, et al. Prognostic value of CA 19-9, CEA, CRP, LDH and bilirubin levels in locally advanced and metastatic pancreatic cancer: results from a multicenter, pooled analysis of patients receiving palliative chemotherapy. J Cancer Res Clin Oncol. 2013;139(4):681–9.

    Article  CAS  PubMed  Google Scholar 

  17. Reitz D, Gerger A, Seidel J, et al. Combination of tumour markers CEA and CA19-9 improves the prognostic prediction in patients with pancreatic cancer. J Clin Pathol. 2015;68(6):427–33.

    Article  CAS  PubMed  Google Scholar 

  18. Tzeng CW, Balachandran A, Ahmad M, et al. Serum carbohydrate antigen 19-9 represents a marker of response to neoadjuvant therapy in patients with borderline resectable pancreatic cancer. HPB (Oxford). 2014;16(5):430–8.

    Article  Google Scholar 

  19. Vainshtein JM, Schipper M, Zalupski MM, et al. Prognostic significance of carbohydrate antigen 19-9 in unresectable locally advanced pancreatic cancer treated with dose-escalated intensity modulated radiation therapy and concurrent full-dose gemcitabine: analysis of a prospective phase 1/2 dose escalation study. Int J Radiat Oncol Biol Phys. 2013;86(1):96–101.

    Article  CAS  PubMed  Google Scholar 

  20. Visser BC, Ma Y, Zak Y, Poultsides GA, Norton JA, Rhoads KF. Failure to comply with NCCN guidelines for the management of pancreatic cancer compromises outcomes. HPB (Oxford). 2012;14(8):539–47.

    Article  Google Scholar 

  21. Jones S, Zhang X, Parsons DW, et al. Core signaling pathways in human pancreatic cancers revealed by global genomic analyses. Science. 2008;321(5897):1801–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Bailey P, Chang DK, Nones K, et al. Genomic analyses identify molecular subtypes of pancreatic cancer. Nature. 2016;531(7592):47–52.

    Article  CAS  PubMed  Google Scholar 

  23. Brunner TB, Geiger M, Grabenbauer GG, et al. Phase I trial of the human immunodeficiency virus protease inhibitor nelfinavir and chemoradiation for locally advanced pancreatic cancer. J Clin Oncol. 2008;26(16):2699–706.

    Article  CAS  PubMed  Google Scholar 

  24. Dholakia AS, Kumar R, Raman SP, et al. Mapping patterns of local recurrence after pancreaticoduodenectomy for pancreatic adenocarcinoma: a new approach to adjuvant radiation field design. Int J Radiat Oncol Biol Phys. 2013;87(5):1007–15.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Gnerlich JL, Luka SR, Deshpande AD, et al. Microscopic margins and patterns of treatment failure in resected pancreatic adenocarcinoma. Arch Surg. 2012;147(8):753–60.

    Article  PubMed  Google Scholar 

  26. Hattangadi JA, Hong TS, Yeap BY, Mamon HJ. Results and patterns of failure in patients treated with adjuvant combined chemoradiation therapy for resected pancreatic adenocarcinoma. Cancer. 2009;115(16):3640–50.

    Article  PubMed  Google Scholar 

  27. Abrams RA, Grochow LB, Chakravarthy A, et al. Intensified adjuvant therapy for pancreatic and periampullary adenocarcinoma: survival results and observations regarding patterns of failure, radiotherapy dose and CA19-9 levels. Int J Radiat Oncol Biol Phys. 1999;44(5):1039–46.

    Article  CAS  PubMed  Google Scholar 

  28. Parikh AA, Maiga A, Bentrem D, et al. Adjuvant therapy in pancreas cancer: does it influence patterns of recurrence? J Am Coll Surg. 2016;222(4):448–56.

    Article  PubMed  Google Scholar 

  29. D'Angelo FA, Antolino L, La Rocca M, et al. Adjuvant and neoadjuvant therapies in resectable pancreatic cancer: a systematic review of randomized controlled trials. Med Oncol. 2016;33(3):28. doi:10.1007/s12032-016-0742-z. Epub 2016 Feb 17

    Article  PubMed  Google Scholar 

  30. Van den Broeck A, Sergeant G, Ectors N, Van Steenbergen W, Aerts R, Topal B. Patterns of recurrence after curative resection of pancreatic ductal adenocarcinoma. Eur J Surg Oncol. 2009;35(6):600–4.

    Article  CAS  PubMed  Google Scholar 

  31. Yovino S, Maidment BW 3rd, Herman JM, et al. Analysis of local control in patients receiving IMRT for resected pancreatic cancers. Int J Radiat Oncol Biol Phys. 2012;83(3):916–920.

    Google Scholar 

  32. Merrell KW, Haddock MG, Quevedo JF, et al. Predictors of locoregional failure and impact on overall survival in patients with resected exocrine pancreatic cancer. Int J Radiat Oncol Biol Phys. 2016;94(3):561–70.

    Article  PubMed  Google Scholar 

  33. Asiyanbola B, Gleisner A, Herman JM, et al. Determining pattern of recurrence following pancreaticoduodenectomy and adjuvant 5-flurouracil-based chemoradiation therapy: effect of number of metastatic lymph nodes and lymph node ratio. J Gastrointest Surg. 2009;13(4):752–9.

    Article  PubMed  Google Scholar 

  34. McDonald AM, Dulaney CR, Lopez-Araujo J, et al. Patterns of failure for lymph node-positive resected pancreatic adenocarcinoma after adjuvant radiotherapy or gemcitabine-based chemotherapy alone. J Gastrointest Cancer. 2015;46(2):149–55.

    Article  CAS  PubMed  Google Scholar 

  35. Downs-Canner S, Zenati M, Boone BA, et al. The indolent nature of pulmonary metastases from ductal adenocarcinoma of the pancreas. J Surg Oncol. 2015;112(1):80–5.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Crane CH, Varadhachary GR, Yordy JS, et al. Phase II trial of cetuximab, gemcitabine, and oxaliplatin followed by chemoradiation with cetuximab for locally advanced (T4) pancreatic adenocarcinoma: correlation of Smad4(Dpc4) immunostaining with pattern of disease progression. J Clin Oncol. 2011;29(22):3037–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Iacobuzio-Donahue CA, Fu B, Yachida S, et al. DPC4 gene status of the primary carcinoma correlates with patterns of failure in patients with pancreatic cancer. J Clin Oncol. 2009;27(11):1806–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Elnahal SM, Pronovost PJ, Herman JM. More than the sum of its parts: how multidisciplinary cancer care can benefit patients, providers, and health systems. J Natl Compr Canc Netw. 2013;11(6):738–42.

    PubMed  Google Scholar 

  39. Elnahal SM, Moningi S, Wild AT, et al. Improving safe patient throughput in a multidisciplinary oncology clinic. Physician Leadersh J. 2015;2(2):56. -60, 62, 64-5

    PubMed  Google Scholar 

  40. Tzeng CW, Tran Cao HS, Lee JE, et al. Treatment sequencing for resectable pancreatic cancer: influence of early metastases and surgical complications on multimodality therapy completion and survival. J Gastrointest Surg. 2014;18(1):16–24. discussion 24-5

    Article  PubMed  Google Scholar 

  41. Blazer M, Wu C, Goldberg RM, et al. Neoadjuvant modified (m) FOLFIRINOX for locally advanced unresectable (LAPC) and borderline resectable (BRPC) adenocarcinoma of the pancreas. Ann Surg Oncol. 2015;22(4):1153–9.

    Article  PubMed  Google Scholar 

  42. Katz MH, Shi Q, Ahmad SA, et al. Preoperative modified FOLFIRINOX treatment followed by capecitabine-based chemoradiation for borderline resectable pancreatic cancer: alliance for clinical trials in oncology trial A021101. JAMA Surg. 2016;151(8):e161137.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Neoptolemos JP, Stocken DD, Friess H, et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med. 2004;350(12):1200–10.

    Article  CAS  PubMed  Google Scholar 

  44. Morganti AG, Falconi M, van Stiphout RG, et al. Multi-institutional pooled analysis on adjuvant chemoradiation in pancreatic cancer. Int J Radiat Oncol Biol Phys. 2014;90(4):911–7.

    Article  PubMed  Google Scholar 

  45. Sajjad M, Batra S, Hoffe S, Kim R, Springett G, Mahipal A. Use of radiation therapy in locally advanced pancreatic cancer improves survival: a SEER database analysis. Am J Clin Oncol. 2016.

    Google Scholar 

  46. Burke EE, Marmor S, Portschy PR, et al. Trends in the use of pre-operative radiation for adenocarcinoma of the pancreas in the united states. HPB (Oxford). 2015;17(6):542–50.

    Article  Google Scholar 

  47. Hsu CC, Herman JM, Corsini MM, et al. Adjuvant chemoradiation for pancreatic adenocarcinoma: the johns hopkins hospital-mayo clinic collaborative study. Ann Surg Oncol. 2010;17(4):981–90.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Herman JM, Swartz MJ, Hsu CC, et al. Analysis of fluorouracil-based adjuvant chemotherapy and radiation after pancreaticoduodenectomy for ductal adenocarcinoma of the pancreas: results of a large, prospectively collected database at the johns hopkins hospital. J Clin Oncol. 2008;26(21):3503–10.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Van Laethem JL, Hammel P, Mornex F, et al. Adjuvant gemcitabine alone versus gemcitabine-based chemoradiotherapy after curative resection for pancreatic cancer: a randomized EORTC-40013-22012/FFCD-9203/GERCOR phase II study. J Clin Oncol. 2010;28(29):4450–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Ma WW, Herman JM, Jimeno A, et al. A tolerability and pharmacokinetic study of adjuvant erlotinib and capecitabine with concurrent radiation in resected pancreatic cancer. Transl Oncol. 2010;3(6):373–9.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Lewis R, Drebin JA, Callery MP, et al. A contemporary analysis of survival for resected pancreatic ductal adenocarcinoma. HPB (Oxford). 2013;15(1):49–60.

    Article  Google Scholar 

  52. Neoptolemos JP, Moore MJ, Cox TF, et al. Effect of adjuvant chemotherapy with fluorouracil plus folinic acid or gemcitabine vs observation on survival in patients with resected periampullary adenocarcinoma: The ESPAC-3 periampullary cancer randomized trial. JAMA. 2012;308(2):147–56.

    Article  CAS  PubMed  Google Scholar 

  53. Oettle H, Neuhaus P, Hochhaus A, et al. Adjuvant chemotherapy with gemcitabine and long-term outcomes among patients with resected pancreatic cancer: the CONKO-001 randomized trial. JAMA. 2013;310(14):1473–81.

    Article  CAS  PubMed  Google Scholar 

  54. Kalser MH, Ellenberg SS. Pancreatic cancer. Adjuvant combined radiation and chemotherapy following curative resection. Arch Surg. 1985;120(8):899–903.

    Article  CAS  PubMed  Google Scholar 

  55. Klinkenbijl JH, Jeekel J, Sahmoud T, et al. Adjuvant radiotherapy and 5-fluorouracil after curative resection of cancer of the pancreas and periampullary region: phase III trial of the EORTC gastrointestinal tract cancer cooperative group. Ann Surg. 1999;230(6):776–782; discussion 782–4.

    Google Scholar 

  56. Neoptolemos JP, Stocken DD, Friess H, et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med. 2004;350(12):1200–10.

    Article  CAS  PubMed  Google Scholar 

  57. Neoptolemos JP, Dunn JA, Stocken DD, et al. Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial. Lancet. 2001;358(9293):1576–85.

    Article  CAS  PubMed  Google Scholar 

  58. Abrams RA, Lillemoe KD, Piantadosi S. Continuing controversy over adjuvant therapy of pancreatic cancer. Lancet. 2001;358(9293):1565–6.

    Article  CAS  PubMed  Google Scholar 

  59. Oettle H, Post S, Neuhaus P, et al. Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial. JAMA. 2007;297(3):267–77.

    Article  CAS  PubMed  Google Scholar 

  60. Neoptolemos JP, Stocken DD, Bassi C, et al. Adjuvant chemotherapy with fluorouracil plus folinic acid vs gemcitabine following pancreatic cancer resection: a randomized controlled trial. JAMA. 2010;304(10):1073–81.

    Article  CAS  PubMed  Google Scholar 

  61. Regine WF, Winter KA, Abrams RA, et al. Fluorouracil vs gemcitabine chemotherapy before and after fluorouracil-based chemoradiation following resection of pancreatic adenocarcinoma: a randomized controlled trial. JAMA. 2008;299(9):1019–26.

    Article  CAS  PubMed  Google Scholar 

  62. Loehrer PJS, Feng Y, Cardenes H, et al. Gemcitabine alone versus gemcitabine plus radiotherapy in patients with locally advanced pancreatic cancer: an eastern cooperative oncology group trial. J Clin Oncol. 2011;29(31):4105–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Mukherjee S, Hurt CN, Bridgewater J, et al. Gemcitabine-based or capecitabine-based chemoradiotherapy for locally advanced pancreatic cancer (SCALOP): a multicentre, randomised, phase 2 trial. Lancet Oncol. 2013;14(4):317–26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Hammel P, Huguet F, Van Laethem JL, et al. Comparison of chemoradiotherapy (CRT) and chemotherapy (CT) in patients with locally advanced pancreatic cancer (LAPC) controlled after 4 months of gencitabine with or without erlotinib: final results of the international phase III LAP 07 study. J Clin Oncol Off J Am Soc Clin Oncol. 2013;31(18_Suppl):LBA4003.

    Google Scholar 

  65. Huguet F, Hammel P, Vernerey D, et al. Impact of chemoradiotherapy on local control and time without treatment in patients with locally advanced pancreatic cancer included in the international phase III LAP 07 study. J Clin Oncol Off J Am Soc Clin Oncol. 2014;32(15_Suppl):4001.

    Google Scholar 

  66. Hammel P, Huguet F, van Laethem JL, et al. Effect of chemoradiotherapy vs chemotherapy on survival in patients with locally advanced pancreatic cancer controlled after 4 months of gemcitabine with or without erlotinib: the LAP07 randomized clinical trial. JAMA. 2016;315(17):1844–53.

    Article  CAS  PubMed  Google Scholar 

  67. Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;364(19):1817–25.

    Article  CAS  PubMed  Google Scholar 

  68. Marthey L, Sa-Cunha A, Blanc JF, et al. FOLFIRINOX for locally advanced pancreatic adenocarcinoma: results of an AGEO multicenter prospective observational cohort. Ann Surg Oncol. 2015;22(1):295–301.

    Article  CAS  PubMed  Google Scholar 

  69. Von Hoff DD, Ervin T, Arena FP, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 2013;369(18):1691–703.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Bilimoria KY, Bentrem DJ, Ko CY, Stewart AK, Winchester DP, Talamonti MS. National failure to operate on early stage pancreatic cancer. Ann Surg. 2007;246(2):173–80.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Ben-Josef E, Schipper M, Francis IR, et al. A phase I/II trial of intensity modulated radiation (IMRT) dose escalation with concurrent fixed-dose rate gemcitabine (FDR-G) in patients with unresectable pancreatic cancer. Int J Radiat Oncol Biol Phys. 2012;84(5):1166–71.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Pollom EL, Alagappan M, von Eyben R, et al. Single- versus multifraction stereotactic body radiation therapy for pancreatic adenocarcinoma: outcomes and toxicity. Int J Radiat Oncol Biol Phys. 2014;90(4):918–25.

    Article  PubMed  Google Scholar 

  73. Schellenberg D, Kim J, Christman-Skieller C, et al. Single-fraction stereotactic body radiation therapy and sequential gemcitabine for the treatment of locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys. 2011;81(1):181–8.

    Article  PubMed  Google Scholar 

  74. Goyal K, Einstein D, Ibarra RA, et al. Stereotactic body radiation therapy for nonresectable tumors of the pancreas. J Surg Res. 2012;174(2):319–25.

    Article  PubMed  Google Scholar 

  75. Gurka MK, Collins SP, Slack R, et al. Stereotactic body radiation therapy with concurrent full-dose gemcitabine for locally advanced pancreatic cancer: a pilot trial demonstrating safety. Radiat Oncol. 2013;8:44. doi:10.1186/1748-717X-8-44.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Tozzi A, Comito T, Alongi F, et al. SBRT in unresectable advanced pancreatic cancer: preliminary results of a mono-institutional experience. Radiat Oncol. 2013;8:148. doi:10.1186/1748-717X-8-148.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Herman JM, Chang DT, Goodman KA, et al. Phase 2 multi-institutional trial evaluating gemcitabine and stereotactic body radiotherapy for patients with locally advanced unresectable pancreatic adenocarcinoma. Cancer. 2015;121(7):1128–37.

    Article  CAS  PubMed  Google Scholar 

  78. Moningi S, Dholakia AS, Raman SP, et al. The role of stereotactic body radiation therapy for pancreatic cancer: a single-institution experience. Ann Surg Oncol. 2015;22(7):2352–8.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Koong AC, Christofferson E, Le QT, et al. Phase II study to assess the efficacy of conventionally fractionated radiotherapy followed by a stereotactic radiosurgery boost in patients with locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys. 2005;63(2):320–3.

    Article  PubMed  Google Scholar 

  80. Rwigema JC, Heron DE, Parikh SD, et al. Adjuvant stereotactic body radiotherapy for resected pancreatic adenocarcinoma with close or positive margins. J Gastrointest Cancer. 2012;43(1):70–6.

    Article  PubMed  Google Scholar 

  81. Chuong MD, Springett GM, Freilich JM, et al. Stereotactic body radiation therapy for locally advanced and borderline resectable pancreatic cancer is effective and well tolerated. Int J Radiat Oncol Biol Phys. 2013;86(3):516–22.

    Article  PubMed  Google Scholar 

  82. Polistina F, Costantin G, Casamassima F, et al. Unresectable locally advanced pancreatic cancer: a multimodal treatment using neoadjuvant chemoradiotherapy (gemcitabine plus stereotactic radiosurgery) and subsequent surgical exploration. Ann Surg Oncol. 2010;17(8):2092–101.

    Article  PubMed  Google Scholar 

  83. Chang DT, Schellenberg D, Shen J, et al. Stereotactic radiotherapy for unresectable adenocarcinoma of the pancreas. Cancer. 2009;115(3):665–72.

    Article  PubMed  Google Scholar 

  84. Mahadevan A, Jain S, Goldstein M, et al. Stereotactic body radiotherapy and gemcitabine for locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys. 2010;78(3):735–42.

    Article  PubMed  Google Scholar 

  85. Hoyer M, Roed H, Sengelov L, et al. Phase-II study on stereotactic radiotherapy of locally advanced pancreatic carcinoma. Radiother Oncol. 2005;76(1):48–53.

    Article  PubMed  Google Scholar 

  86. Schellenberg D, Goodman KA, Lee F, et al. Gemcitabine chemotherapy and single-fraction stereotactic body radiotherapy for locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys. 2008;72(3):678–86.

    Article  CAS  PubMed  Google Scholar 

  87. Boone BA, Steve J, Krasinskas AM, et al. Outcomes with FOLFIRINOX for borderline resectable and locally unresectable pancreatic cancer. J Surg Oncol. 2013;108(4):236–41.

    Article  CAS  PubMed  Google Scholar 

  88. Rajagopalan MS, Heron DE, Wegner RE, et al. Pathologic response with neoadjuvant chemotherapy and stereotactic body radiotherapy for borderline resectable and locally-advanced pancreatic cancer. Radiat Oncol. 2013;8:254. doi:10.1186/1748-717X-8-254.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Mellon EA, Hoffe SE, Springett GM, et al. Long-term outcomes of induction chemotherapy and neoadjuvant stereotactic body radiotherapy for borderline resectable and locally advanced pancreatic adenocarcinoma. Acta Oncol. 2015;54(7):979–85.

    Article  CAS  PubMed  Google Scholar 

  90. Wild AT, Hiniker SM, Chang DT, et al. Re-irradiation with stereotactic body radiation therapy as a novel treatment option for isolated local recurrence of pancreatic cancer after multimodality therapy: experience from two institutions. J Gastrointest Oncol. 2013;4(4):343–51.

    PubMed  PubMed Central  Google Scholar 

  91. Dagoglu N, Callery M, Moser J, et al. Stereotactic body radiotherapy (SBRT) reirradiation for recurrent pancreas cancer. J Cancer. 2016;7(3):283–8.

    Article  PubMed  PubMed Central  Google Scholar 

  92. Katz MH, Marsh R, Herman JM, et al. Borderline resectable pancreatic cancer: need for standardization and methods for optimal clinical trial design. Ann Surg Oncol. 2013;20(8):2787–95.

    Article  PubMed  Google Scholar 

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Burkhart, R.A., Rosati, L.M., Herman, J.M. (2017). Pancreatic Cancer: Background and Clinical Evidence. In: Hong, T., Das, P. (eds) Radiation Therapy for Gastrointestinal Cancers. Springer, Cham. https://doi.org/10.1007/978-3-319-43115-4_7

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