TY - JOUR
T1 - Neoadjuvant Treatment for Resectable and Borderline Resectable Pancreatic Cancer
T2 - Chemotherapy or Chemoradiotherapy?
AU - Versteijne, Eva
AU - de Hingh, Ignace H. J. T.
AU - Homs, Marjolein Y. V.
AU - Intven, Martijn P. W.
AU - Klaase, Joost M.
AU - van Santvoort, Hjalmar C.
AU - de Vos-Geelen, Judith
AU - Wilmink, Johanna W.
AU - van Tienhoven, Geertjan
N1 - Publisher Copyright: Copyright © 2022 Versteijne, de Hingh, Homs, Intven, Klaase, van Santvoort, de Vos-Geelen, Wilmink and van Tienhoven.
PY - 2022/2/14
Y1 - 2022/2/14
N2 - Worldwide, there is a shifting paradigm from immediate surgery with adjuvant treatment to a neoadjuvant approach for patients with resectable or borderline resectable pancreatic cancer (RPC or BRPC). Comparison of neoadjuvant and adjuvant studies is extremely difficult because of a great difference in patient selection. The evidence from randomized studies shows that overall survival by intention-to-treat improves after neoadjuvant gemcitabine-based chemoradiotherapy or chemotherapy (various regimens), as compared to immediate surgery followed by adjuvant chemotherapy. Radiotherapy appears to play an important role in mediating locoregional effects. Yet, since more effective chemotherapy regimens are currently available, in particular FOLFIRINOX and Gemcitabine/Nab-paclitaxel, these chemotherapy regimens should be investigated in future randomized trials combined with (stereotactic) radiotherapy to further improve outcomes of RPC and BRPC.
AB - Worldwide, there is a shifting paradigm from immediate surgery with adjuvant treatment to a neoadjuvant approach for patients with resectable or borderline resectable pancreatic cancer (RPC or BRPC). Comparison of neoadjuvant and adjuvant studies is extremely difficult because of a great difference in patient selection. The evidence from randomized studies shows that overall survival by intention-to-treat improves after neoadjuvant gemcitabine-based chemoradiotherapy or chemotherapy (various regimens), as compared to immediate surgery followed by adjuvant chemotherapy. Radiotherapy appears to play an important role in mediating locoregional effects. Yet, since more effective chemotherapy regimens are currently available, in particular FOLFIRINOX and Gemcitabine/Nab-paclitaxel, these chemotherapy regimens should be investigated in future randomized trials combined with (stereotactic) radiotherapy to further improve outcomes of RPC and BRPC.
KW - borderline resectable pancreatic cancer (BRPC)
KW - chemotherapy
KW - neoadjuvant treatment
KW - radiotherapy
KW - resectable pancreatic cancer (RPC)
UR - http://www.scopus.com/inward/record.url?scp=85125403771&partnerID=8YFLogxK
U2 - https://doi.org/10.3389/fonc.2021.744161
DO - https://doi.org/10.3389/fonc.2021.744161
M3 - Review article
C2 - 35237500
SN - 2234-943X
VL - 11
JO - Frontiers in Oncology
JF - Frontiers in Oncology
M1 - 744161
ER -