VMAT for early pancreatic adenocarcinoma in case where surgery is contraindicated

Abstract

There are several methods for managing pancreatic cancer. Surgical resection gives the best chance for a possible cure in the early stages of the disease. However only 10-20% of patients present with potentially resectable pancreatic cancer. Chemotherapy is the treatment of choice for the advanced metastatic disease. For locally advanced, inoperable pancreatic cancer, combined chemotherapy and radiation is the preferred treatment.1 In the case of patients who have contraindications for surgery, concurrent chemoradiation may be chosen2. The patient in this study, was a case of adenocarcinoma at the pancreatic head, stage T1N0M0, with underlying heart disease; she thus was contraindicated for a major operation. The treatment plan was chemoradiation, using VMAT radiotherapy technique with a radiation dose of 45Gy in 25 fractions and oral Xeloda.