Copyright
©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2019; 11(7): 303-307
Published online Jul 27, 2019. doi: 10.4240/wjgs.v11.i7.303
Published online Jul 27, 2019. doi: 10.4240/wjgs.v11.i7.303
Optimizing neoadjuvant radiotherapy for resectable and borderline resectable pancreatic cancer using protons
Romaine Charles Nichols, Michael Rutenberg, Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL 32206, United States
Author contributions: Nichols RC and Rutenberg MS equally contributed to this paper.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose. Funding: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: Romaine Charles Nichols, MD, Associate Professor, Department of Radiation Oncology, University of Florida College of Medicine, 015 North Jefferson Street, Jacksonville, FL 32206, United States. rnichols@floridaproton.org
Telephone: +1-904-5881245 Fax: +1-904-5881300
Received: May 16, 2019
Peer-review started: May 20, 2019
First decision: May 31, 2019
Revised: June 25, 2019
Accepted: July 25, 2019
Article in press: July 26, 2019
Published online: July 27, 2019
Processing time: 72 Days and 13 Hours
Peer-review started: May 20, 2019
First decision: May 31, 2019
Revised: June 25, 2019
Accepted: July 25, 2019
Article in press: July 26, 2019
Published online: July 27, 2019
Processing time: 72 Days and 13 Hours
Core Tip
Core tip: Patients with resectable and borderline resectable pancreatic cancer are at a high risk of suffering postoperative local-regional failure. Preoperative radiotherapy directed to gross disease and regional lymphatic beds at high risk of harboring microscopic disease appears to be an oncologically rational intervention to reduce this risk. When proton-based radiotherapy addressing gross disease as well as high-risk regional lymphatic beds is delivered prior to surgery, it does not appear to increase the risk of surgical complications or the duration of surgery. Because of this, we would argue that proton-based preoperative radiotherapy should be considered for patients with resectable and borderline resectable disease.