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Can Combined Chemoradiotherapy Turn Inoperable Pancreatic Cancer Into Operable?

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Benefit of Chemoradiotherapy Versus Chemotherapy After Induction Therapy for Resectable Pancreatic Cancer The Randomized CONKO 007 Trial DOI 10.1200JCO 24 01502

Pancreatic cancer is one of the hardest cancers to treat, especially when the tumor can’t be removed by surgery at first. Doctors often try chemotherapy to shrink the tumor and make surgery possible. This study looked at whether adding radiation to chemotherapy could help more people reach that goal.

Over 500 people with advanced pancreatic cancer took part in this study. All started with chemotherapy. After 3 months, those whose cancer had not grown were split into two groups: one group continued chemotherapy, and the other added radiation therapy (chemoradiotherapy).

The main question was: could this combination help doctors remove the tumor completely (called an R0 resection)?

Here’s what they found:

⦿ The number of people who had their tumor fully removed was slightly higher in the radiation group (25%) than in the chemo-only group (18%), but the difference was not big enough to be certain.

⦿ Among patients who did go to surgery, the radiation group had better results—69% had no cancer left at the edges of the removed tissue, compared to 50% in the chemo-only group.

⦿ Both groups had similar overall survival, but patients who had surgery lived longer than those who didn’t.

The takeaway: radiation after chemotherapy didn’t help everyone, but for those able to have surgery, it increased the chance of fully removing the tumor.

If you’re facing pancreatic cancer that can’t be removed yet, ask your doctor whether chemoradiotherapy might help make surgery possible.

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Dr. Harsh J Shah

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Dr Harsh Shah - GI & HPB Oncosurgeon in India
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