Flashcards in B12. Radiotherapy, surgical and pharmacological treatment of pancreatic cancer Deck (21):
What is the preferred treatment for pancreatic tumors
Often unresectable but if operable should be managed surgically
What should chemotherapy be used for pancreatic carcinoma?
When is unresectable, locally, or locoregionally, metastatic tumors
Is adjuvant or radiotherapy indicated pancreatic tumors
Post surgical chemotherapy adjuvant chemotherapy is recommended (standard in US), while radiotherapy is CI
The most common obstacle in surgery
Tumor spreads toward the retroperitoneum and propagation to mesenteric vein and superior portal vein
Standard surgery for pancreatic carcinoma?
Most common surgery for body and tail of pancreas?
Distal pancreaticosplenectomy is most common
First step if preoperative imaging shows doubtful resection
Neoadjuvant chemotherapy or chemoradiotherapy
How to reconstruct the upper GI tract after pancreaticoduodectomy
Anastomose the pancreatic stump, choledochal duct and gastric stump into the jejunum
What is it called when the pancreatic stump is implanted into the stomach
Flaunter and Tihanyi
What happens if it is a distal pancreaticosplenectomy
Total pancreatectomy is indicated when
Multiple tumor nodules are present
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
The palliative treatment for the obstruction of the bile duct
Endoscopic bare-metal stenting
Where does the adenocarcinomas typically originate from?
95% of the adenocarcinomas originate from the exocrine portion of the pancreas
% 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
Postoperative Pancreatic carcinoma adjuvant chemotherapy consists of?
Gemcitabine and capecitabine
3 Main Chemo combinations treatments for pancreatic carcinoma
-FOLFIRINOX: oxaliplatin, irinotecan, 5-fluorouracil, folinic acid
-Gemcitabine + nab-paclitaxel
-Gemcitabine + 5-FU
Monotherapy for pancreatic carcinoma chemo if pt isn’t in general condition
When can controversial radiotherapy be used for pancreatic cancer?
Local recurrence of pancreatic cancer. Typically given as chemoradiotherapy.