Minireviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Dec 15, 2021; 13(12): 2064-2075
Published online Dec 15, 2021. doi: 10.4251/wjgo.v13.i12.2064
Current status of non-surgical treatment of locally advanced pancreatic cancer
Stavros Spiliopoulos, Maria Teresa Zurlo, Annachiara Casella, Letizia Laera, Giammarco Surico, Alessia Surgo, Alba Fiorentino, Nicola de'Angelis, Roberto Calbi, Riccardo Memeo, Riccardo Inchingolo
Stavros Spiliopoulos, 2nd Radiology Department, Interventional Radiology Unit, National and Kapodistrian University of Athens, Athens 12461, Greece
Maria Teresa Zurlo, Riccardo Inchingolo, Interventional Radiology Unit, “F. Miulli” Regional General Hospital, Acquaviva delle Fonti 70021, Italy
Annachiara Casella, Riccardo Memeo, Unit of Hepato-Pancreatic-Biliary Surgery, “F. Miulli” Regional General Hospital, Acquaviva delle Fonti 70021, Italy
Letizia Laera, Giammarco Surico, Department of Oncology, General Regional Hospital “F. Miulli”, Acquaviva delle Fonti 70021, Italy
Alessia Surgo, Alba Fiorentino, Department of Radiation Oncology, “F. Miulli” Regional General Hospital, Acquaviva delle Fonti 70021, Italy
Nicola de'Angelis, Unit of Minimally Invasive and Robotic Digestive Surgery, “F. Miulli” Regional General Hospital, Acquaviva delle Fonti 70021, Italy
Roberto Calbi, Department of Radiology, General Regional Hospital “F. Miulli”, Acquaviva delle Fonti 70021, Italy
Author contributions: Spiliopoulos S, Zurlo MT, Casella A, Laera L, Surico G, Surgo A, Fiorentino A, de'Angelis N, Calbi R, Memeo R and Inchingolo R contributed data collection and manuscript writing, data analysis, and review design and supervision; all authors equally contributed to this paper with the conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: The authors state that they have no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Stavros Spiliopoulos, MD, PhD, Associate Professor, 2nd Radiology Department, Interventional Radiology Unit, National and Kapodistrian University of Athens, 1st Rimini St, Chaidari, Athens 12461, Greece. stavspiliop@med.uoa.gr
Received: March 22, 2021
Peer-review started: March 22, 2021
First decision: June 16, 2021
Revised: June 28, 2021
Accepted: October 25, 2021
Article in press: October 25, 2021
Published online: December 15, 2021
Processing time: 267 Days and 2.6 Hours
Abstract

Pancreatic cancer is the 7th leading cause of death due to cancer in industrialized countries and the 11th most common cancer globally, with 458918 new cases (2.5% of all cancers) and 432242 deaths (4.5% of all cancer deaths) in 2018. Unfortunately, 80% to 90% of the patients present with unresectable disease, and the reported 5-year survival rate range between 10% and 25%, even after successful resection with tumor-free margins. Systemic chemotherapy, radiotherapy, and minimally invasive image-guided procedures that have emerged over the past years, are used for the management of non-operable PC. This review focuses on currently available non-surgical options of locally advanced pancreatic cancer.

Keywords: Interventional radiology; Oncology; Radiotherapy; Pancreatic cancer; Ablation

Core Tip: Currently available non-surgical treatment options for locally advanced pancreatic cancer include systemic chemotherapy, radiotherapy, and minimally invasive image-guided procedures. The latter have emerged over the past years and include radiofrequency, microwave ablation, laser ablation, cryoablation, irreversible electroporation, high intensity focused ultrasound, and trans-arterial embolization procedures. Although initial results were not deemed satisfactory, mainly due to unacceptable complication rates, cumulative experience and technological advances have led to the improvement of outcomes of image-guided procedures and their incorporation in the treatment algorithm.