SBRT appears to have a survival benefit in patients with locally advanced pancreatic cancer, especially after the delivery of maximal multiagent chemotherapy. SBRT may play a role in tumor downstaging and allow patients with locally advanced pancreatic cancer to undergo surgery.
Intraductal papillary mucinous neoplasms with high malignant potential appear to have distinct imaging properties. Further validation of these findings may address a major clinical need in this population by identifying those most likely to benefit from surgical resection.
We conclude that every patient has the right to have continent diversion. An orthotopic bladder approach should be considered first, and if it is not feasible, then the Indiana pouch could be a suitable alternative with no additional complications, unless this procedure is contraindicated.
L5HU and psoas L4–L5, surrogates for bone mineral density and muscle mass, respectively, were independent predictors of overall survival in a multivariable model controlling for age, comorbidity, prostate cancer risk grouping, race, and ADT.
Rates of clinically significant GI and GU toxicities are modest following SBRT plus IMRT. Placement of rectal spacers may decrease rectal toxicity. Future studies should also identify dosimetric predictors of these toxicities.
Increasing time from diagnosis to simulation and from simulation until the start of therapy is associated with worse outcomes. Patients with HPV-associated oropharyngeal squamous cell carcinoma are at increased risk of nodal progression before treatment.
From our institutional experience, low-dose RT in addition to docetaxel and cetuximab is well tolerated. More durable treatment options may exist for definitive treatment; however, this protocol may offer low-morbidity palliation in select patients.