What are the treatment options for borderline resectable pancreatic cancer?

What are the treatment options for borderline resectable pancreatic cancer?

Treatment for borderline resectable pancreatic cancer aims to reduce the size of the tumour using chemotherapy and chemoradiotherapy, potentially making resection possible.

Chemotherapy

Borderline resectable pancreatic cancer may be initially treated with neoadjuvant chemotherapy. Gemcitabine or FOLFIRINOX are most commonly used in this setting. However, patients with borderline resectable tumours are included in clinical trials whenever possible, so other neoadjuvant treatments may be offered (see section ‘Clinical trials’ for more information) (Ducreux et al., 2015).

Chemoradiotherapy

Following the period of neoadjuvant chemotherapy, patients may have a course of chemoradiotherapy to help try to convert the tumour from borderline resectable to resectable (Ducreux et al., 2015).

Initial treatment for borderline resectable pancreatic cancer aims to reduce the size of the tumour and make it resectable

Surgery

After neoadjuvant treatment with chemotherapy and chemoradiotherapy, the tumour will be re assessed to see if it is now resectable. Patients with tumours that are resectable will undergo surgery, possibly followed by adjuvant chemotherapy (see section ‘What are the treatment options for resectable pancreatic cancer?’ for more information). Patients whose tumours remain unresectable may be offered further chemotherapy.