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Radiation Therapy for Pancreatic Cancer: Executive Summary of an ASTRO Clinical Practice Guideline.

Publication ,  Journal Article
Palta, M; Godfrey, D; Goodman, KA; Hoffe, S; Dawson, LA; Dessert, D; Hall, WA; Herman, JM; Khorana, AA; Merchant, N; Parekh, A; Patton, C ...
Published in: Pract Radiat Oncol
2019

PURPOSE: This guideline systematically reviews the evidence for treatment of pancreatic cancer with radiation in the adjuvant, neoadjuvant, definitive, and palliative settings and provides recommendations on indications and technical considerations. METHODS AND MATERIALS: The American Society for Radiation Oncology convened a task force to address 7 key questions focused on radiation therapy, including dose fractionation and treatment volumes, simulation and treatment planning, and prevention of radiation-associated toxicities. Recommendations were based on a systematic literature review and created using a predefined consensus-building methodology and system for grading evidence quality and recommendation strength. RESULTS: The guideline conditionally recommends conventionally fractionated or stereotactic body radiation for neoadjuvant and definitive therapy in certain patients and conventionally fractionated regimens for adjuvant therapy. The task force suggests a range of appropriate dose-fractionation schemes and provides recommendations on target volumes and sequencing of radiation and chemotherapy. Motion management, daily image guidance, use of contrast, and treatment with modulated techniques are all recommended. The task force supported prophylactic antiemetic medication, and patients may also benefit from medications to reduce acid secretion. CONCLUSIONS: The role of radiation in the management of pancreatic cancer is evolving, with many ongoing areas of active investigation. Radiation therapy is likely to become even more important as new systemic therapies are developed and there is increased focus on controlling local disease. It is important that the nuances of available data are discussed with patients and families and that care be coordinated in a multidisciplinary fashion.

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Published In

Pract Radiat Oncol

DOI

EISSN

1879-8519

Publication Date

2019

Volume

9

Issue

5

Start / End Page

322 / 332

Location

United States

Related Subject Headings

  • Systematic Reviews as Topic
  • Pancreatic Neoplasms
  • Humans
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences
 

Citation

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Chicago
ICMJE
MLA
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Palta, M., Godfrey, D., Goodman, K. A., Hoffe, S., Dawson, L. A., Dessert, D., … Koong, A. C. (2019). Radiation Therapy for Pancreatic Cancer: Executive Summary of an ASTRO Clinical Practice Guideline. Pract Radiat Oncol, 9(5), 322–332. https://doi.org/10.1016/j.prro.2019.06.016
Palta, Manisha, Devon Godfrey, Karyn A. Goodman, Sarah Hoffe, Laura A. Dawson, David Dessert, William A. Hall, et al. “Radiation Therapy for Pancreatic Cancer: Executive Summary of an ASTRO Clinical Practice Guideline.Pract Radiat Oncol 9, no. 5 (2019): 322–32. https://doi.org/10.1016/j.prro.2019.06.016.
Palta M, Godfrey D, Goodman KA, Hoffe S, Dawson LA, Dessert D, et al. Radiation Therapy for Pancreatic Cancer: Executive Summary of an ASTRO Clinical Practice Guideline. Pract Radiat Oncol. 2019;9(5):322–32.
Palta, Manisha, et al. “Radiation Therapy for Pancreatic Cancer: Executive Summary of an ASTRO Clinical Practice Guideline.Pract Radiat Oncol, vol. 9, no. 5, 2019, pp. 322–32. Pubmed, doi:10.1016/j.prro.2019.06.016.
Palta M, Godfrey D, Goodman KA, Hoffe S, Dawson LA, Dessert D, Hall WA, Herman JM, Khorana AA, Merchant N, Parekh A, Patton C, Pepek JM, Salama JK, Tuli R, Koong AC. Radiation Therapy for Pancreatic Cancer: Executive Summary of an ASTRO Clinical Practice Guideline. Pract Radiat Oncol. 2019;9(5):322–332.
Journal cover image

Published In

Pract Radiat Oncol

DOI

EISSN

1879-8519

Publication Date

2019

Volume

9

Issue

5

Start / End Page

322 / 332

Location

United States

Related Subject Headings

  • Systematic Reviews as Topic
  • Pancreatic Neoplasms
  • Humans
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences