B12. Radiotherapy, surgical and pharmacological treatment of pancreatic cancer  Flashcards Preview

Oncology > B12. Radiotherapy, surgical and pharmacological treatment of pancreatic cancer  > Flashcards

Flashcards in B12. Radiotherapy, surgical and pharmacological treatment of pancreatic cancer  Deck (21):
1

What is the preferred treatment for pancreatic tumors

Often unresectable but if operable should be managed surgically

2

What should chemotherapy be used for pancreatic carcinoma?

When is unresectable, locally, or locoregionally, metastatic tumors

3

Is adjuvant or radiotherapy indicated pancreatic tumors

Post surgical chemotherapy adjuvant chemotherapy is recommended (standard in US), while radiotherapy is CI

4

The most common obstacle in surgery

Tumor spreads toward the retroperitoneum and propagation to mesenteric vein and superior portal vein

5

Standard surgery for pancreatic carcinoma?

Pancreaticoduodenectomy

6

Most common surgery for body and tail of pancreas?

Distal pancreaticosplenectomy is most common

7

First step if preoperative imaging shows doubtful resection

Neoadjuvant chemotherapy or chemoradiotherapy

8

How to reconstruct the upper GI tract after pancreaticoduodectomy

Whipple procedure

9

Whipple procedure

Anastomose the pancreatic stump, choledochal duct and gastric stump into the jejunum

10

What is it called when the pancreatic stump is implanted into the stomach

Flaunter and Tihanyi

11

What happens if it is a distal pancreaticosplenectomy

No reconstruction

12

Total pancreatectomy is indicated when

Multiple tumor nodules are present

13

Tumors of the head of the pancreas cause which complications? Uncinate process? Body and tail?

Head of pancreas=icterus
Uncinate process=obstruction of the duodenum
Body and tail= obstruction of the GI tract

14

The palliative treatment for the obstruction of the bile duct

Endoscopic bare-metal stenting

15

Where does the adenocarcinomas typically originate from?

95% of the adenocarcinomas originate from the exocrine portion of the pancreas

16

% of pts who can undergo curative surgery? 5 year survival of pts who underwent surgery?

10-20% can do the surgery and only 10-25% survive

17

Postoperative Pancreatic carcinoma adjuvant chemotherapy consists of?

Gemcitabine and capecitabine

18

3 Main Chemo combinations treatments for pancreatic carcinoma

-FOLFIRINOX: oxaliplatin, irinotecan, 5-fluorouracil, folinic acid
-Gemcitabine + nab-paclitaxel
-Gemcitabine + 5-FU

19

Monotherapy for pancreatic carcinoma chemo if pt isn’t in general condition

Gemcitabine

20

When can controversial radiotherapy be used for pancreatic cancer?

Local recurrence of pancreatic cancer. Typically given as chemoradiotherapy.

21

Newest radiotherapy technique in pancreatic cancer

Stereotactic ablative radiotherapy (SABRT)