Radiation therapy plays an important complementary role in the care of patients with pancreatic cancer. While not considered curative when used as sole therapy, it may decrease the risk of recurrence after surgical removal of the tumor. It also plays an important role in treating painful deposits of cancer that can not be surgically removed.
Clinical trials in the 1980s resulted in data supporting the postoperative treatment of patients with pancreatic cancer utilizing external beam radiation in conjunction with chemotherapy. Patients experienced significantly fewer local recurrences and there was some evidence that their chance for long- term survival was increased. While subsequent trials have raised further questions about the effectiveness of adjuvant radiation in improving long- term survival, this modality continues to be routinely recommended for many patients who have had potentially curative surgery for pancreatic cancer.
Primary high-dose radiosurgery with the CyberKnife may be considered for patients with unresectable initial or recurrent pancreatic cancer. Data supporting its efficacy in providing long-term benefits are forthcoming but initial clinical experience is encouraging. Concerns about radiation toxicity to adjacent structures limit the potential for local control compared to surgery.
Patients with painful recurrences of pancreatic cancer may experience significant relief from palliative radiation therapy, often in conjunction with systemic agents such as Gemcytabine.