Venous Shunting Procedures for Borderline Resectable Pancreatic Cancer
Fig. 15.1 (a, b) Coronal CT images of anatomic variations of the IMV insertion site. In Fig. 15.1a, the IMV drains into the SMV (Arrow) whereas in Fig. 15.1b, the…
The Role of Irreversible Electroporation and Other Ablative Techniques in Patients with Borderline Resectable Pancreatic Cancer
Author Premalignant lesion n Treatment Median area of ablation, mm (range) Outcome Complications Gan, et al. Cystic tumors of the pancreas 25 EUS-guided ethanol lavage 19.4 (6–30) Complete resolution in…
Role of Radiation Therapy
AHPBA/SSAT/SSO MD Anderson NCCN 2012a Intergroup trial SMV-PV Abutmentb, encasementc, or occlusion Occlusion Abutment with impingement or narrowing Interface between tumor and vessel measuring 180° or greater of the…
Palliative Operations for Unresectable Pancreatic Cancer
Author Year N Technical success (%) Morbidity (%) Mortality (%) Recurrence (%) Stent Surgery Stent Surgery Stent Surgery Stent Surgery Bornman et al. 1986 50 84 76 28 32 8…
Stereotactic Body Radiation Therapy as an Emerging Option for Localized Pancreatic Cancer
Fig. 8.1 Computed tomography scan of a locally advanced tumor (a) prior to chemotherapy and (b) following chemotherapy and SBRT to 33 Gy in 5 fractions. Patient then underwent a…
Operative Principles in Managing Patients with Borderline Resectable Pancreas Cancer
Fig. 11.1 Computed tomography scan of patient with BRPC due to hepatic arterial involvement both before (a) and after (b) neoadjuvant therapy with FOLFIRINOX. The tumor can be seen encasing…
Assessment of Response to Preoperative Therapy
Response criteria Groups Definition Advantages Disadvantages References Radiologic RECIST Complete response Disappearance – Objective, well-evaluated response measure in solid tumors – Not well established in BRCP and LAPC [12] Partial…
Role of Systemic Therapy
Reference BRPC cases Regiment Number resected (%) R0 resection (%) OS, all pts (mo) OS, resected pts (mo) Turrini [85] 49 5-FU/Cis + XRT 9 b b b Chun [24] 74 5-FU/Gem + XRT…
Emerging Systemic and Targeted Therapies
Fig. 10.1 Development of new drugs and regimens in the treatment of pancreatic cancer. Drugs or regimen activity demonstrated in a phase III study. Not all agents are approved by…
Overview of Multimodality Therapy
Setting Study Regimen Goal Opened Borderline resectable ALLIANCE A021101 mFFX—no 5FU bolus—4 cycles, then RT/cape; gemcit postop Accrual rate, toxicity, CR/PR, completion of all therapy, R0/R1 March 2013 Pilot study…
