Chemoradiation after FOLFIRINOX for borderline resectable or locally advanced pancreatic cancer.

Background: The safety and efficacy of FOLFIRINOX (FX) followed by consolidative chemoradiation (CRT) in borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) has not been extensively studied. We sought to evaluate outcomes and toxicities of this regimen.

Methods: A retrospective review was performed of 33 patients with BRPC or LAPC treated with FX followed by CRT.

A Long-Term Survivor of Metastatic Pancreatic Adenocarcinoma: Free of Recurrence 12 Years After Treatment of Oligometastatic Disease.

Aggressive local therapy for patients with oligometastatic pancreatic ductal adenocarcinoma (PDAC) has traditionally not been pursued due to high rates of distant progression. We describe a 62-year-old male initially presenting with resectable PDAC who underwent the Whipple procedure but developed multiple liver metastases within two months of starting adjuvant gemcitabine. Oxaliplatin was added to the regimen and complete resolution of the liver lesions resulted.

Capecitabine as a Radiosensitizer in Adjuvant Chemoradiotherapy for Pancreatic Cancer: A Retrospective Study.

Aim: Pancreatic cancer remains one of the deadliest cancer diagnoses and is the fourth leading cause of cancer-related deaths in the U.S. Surgery is the mainstay of treatment for the 20% for whom the tumor is resectable, however, controversy exists over the appropriate adjuvant therapy where local recurrence rates remain strikingly high (50-85%).

Locally advanced unresectable pancreatic cancer.

Twenty-five percent of patients with pancreatic cancer present with locally advanced disease that is unresectable, and the treatment strategy for these patients is controversial, with options including chemotherapy alone, concurrent chemoradiation, or induction chemotherapy followed by chemoradiation. Abstracts presented at the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting (#4001, #4126, and #4024) addressed local control, quality of life, and prognostic factors associated with current regimens of induction chemotherapy and subsequent chemoradiation.

Current strategies in chemoradiation for esophageal cancer.

Chemoradiotherapy (CRT) has an important role in the treatment of esophageal cancer in both the inoperable and the pre-operative settings. Pre-operative chemoradiation therapy is generally given to 41.4-50.

The effect of a lung cancer care coordination program on timeliness of care.

Background: Timeliness of care improves patient satisfaction and might improve outcomes. The CCCP was established in November 2007 to improve timeliness of care of NSCLC at the Veterans Affairs Connecticut Healthcare System (VACHS).

Patients And Methods: We performed a retrospective cohort analysis of patients diagnosed with NSCLC at VACHS between 2005 and 2010.

A comparison of three treatment strategies for locally advanced and borderline resectable pancreatic cancer.

Background: The optimal treatment strategy for locally advanced and borderline resectable pancreatic cancer is not known. We compared overall survival (OS), local control (LC), metastasis free survival (MFS), and percent of patients who were able to undergo successful surgical resection for three treatment strategies.

Methods: We retrospectively reviewed 115 sequentially treated cases of locally advanced (T4) or borderline resectable (T3 but unresectable) pancreatic cancer.

Treatment of locally advanced pancreatic cancer: the role of radiation therapy.

Pancreatic cancer remains associated with an extremely poor prognosis. Surgical resection can be curative, but the majority of patients present with locally advanced or metastatic disease. Treatment for patients with locally advanced disease is controversial.

A novel modified dynamic conformal arc technique for treatment of peripheral lung tumors using stereotactic body radiation therapy.

Purpose: To describe and compare a novel, modified dynamic conformal arc (MDCA) technique for lung stereotactic body radiation therapy with the standard noncoplanar beam (NCB) technique based on stereotactic body radiation therapy (SBRT) coverage, dose conformality, normal tissue constraints, and treatment time.

Materials And Methods: Twenty consecutive medically inoperable patients with early stage, peripheral, non-small cell lung cancer treated with SBRT using an NCB technique were re-planned with a novel MDCA technique. Treatment plans were compared based on Radiation Therapy Oncology Group (RTOG) 0236 criteria for planning treatment volume (PTV) coverage and normal tissue dose constraints, as well as high- and moderate-dose conformality.

Locally advanced pancreatic adenocarcinoma: where are we and where are we going? Highlights from the "2011 ASCO Gastrointestinal Cancers Symposium". San Francisco, CA, USA. January 20-22, 2011.

Eight abstracts highlighting the continued evolution of the management of locally advanced pancreatic cancer were presented at the 2011 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium (Abstracts #195, #239, #259, #281, #287, #305, #307, #324). These studies address key issues including the role of novel targeted therapies, what chemotherapy regimen should be used in conjunction with radiotherapy, and whether locally advanced pancreatic cancer can be managed with chemotherapy alone.

Updates in locally advanced pancreatic cancer. Highlights from the "2010 ASCO Annual Meeting". Chicago, IL, USA. June 4-8, 2010.

Pancreatic cancer is the 4th leading cancer cause mortality in both men and women. Pancreatic cancer is usually diagnosed in the advanced setting, and only 10-15% of patients present with operable disease. About 25% are locally advanced and unresectable and the rest are metastatic.

New developments in the treatment of locally advanced pancreatic cancer. Highlights from the 45th ASCO annual meeting. Orlando, FL, USA. May 29-June 2, 2009.

The results of the trials presented at this year's ASCO annual meeting underline the challenges of not only treating but also studying locally advanced pancreatic cancer, with any appreciable effect of treatment gained at the cost of considerable toxicity. That response was observed in small numbers of patients in the presented trials speaks to the importance of rational selection of treatment in individual patients in order to achieve maximal survival with minimal treatment-associated morbidity. Further understanding of tumor biology and identification of both prognostic and predictive factors will help define personalized treatment approaches for individual patients.

Combining epidermal growth factor receptor inhibitors and radiation therapy in pancreatic cancer: small step or giant leap?

Targeting the epidermal growth factor receptor (EGFR) with small molecule inhibitors or monoclonal antibodies in combination with chemotherapy and radiation is a theoretically appealing strategy in pancreatic cancer. EGFR inhibitors have shown efficacy as radiosensitizers and activity against metastatic pancreatic cancer when combined with gemcitabine. This paper examines the available clinical data, with a focus on locally advanced, unresectable disease.

Stereotactic body radiation therapy (SBRT) in pancreatic cancer: is it ready for prime time?

Pancreatic cancer is a devastating disease with few effective treatment modalities. Stereotactic body radiation therapy is a novel technique that takes advantage of the technologic advancements in image guidance and radiation dose delivery to direct ablative doses to tumors with acceptable toxicity that was not previously achievable with conventional techniques. Recent literature contains reports of stereotactic body radiation therapy in patients with locally advanced pancreatic tumors.

Prognostic significance of cyclooxygenase-2 in oropharyngeal squamous cell carcinoma.

Purpose: To determine the relative prognostic significance of cyclooxygenase (COX)-2 expression in patients with oropharyngeal squamous cell carcinoma (SCC).

Experimental Design: This retrospective cohort study included 82 patients with SCC referred to the Department of Therapeutic Radiology at Yale-New Haven Hospital (Connecticut) between 1980 and 1999 who were treated with primary external beam radiotherapy or gross total surgical resection and postoperative radiotherapy. A microarray of archival tumor tissue was constructed and stained with monoclonal antibodies directed against COX-2 and scored for intensity by a pathologist blinded to the clinical outcomes of the patients.