ASTRO updates radiation therapy guidelines for pancreatic cancer

The American Society for Radiation Oncology (ASTRO) has released updated clinical practice guidelines regarding the use of radiation therapy for adult patients with pancreatic cancer. This update replaces the society’s 2019 recommendations, incorporating recent randomized trial evidence from studies such as CONKO-007, PREOPANC, and Alliance A021501.

The new guidelines expand radiotherapy recommendations across resectable, locally advanced, recurrent, and metastatic settings. For resectable disease, the guideline conditionally recommends preoperative chemoradiation. For borderline resectable disease, preoperative radiation or chemoradiation is recommended to improve local control and increase the likelihood of margin-negative resection.

Developed in collaboration with the American Society of Clinical Oncology, the European Society of Radiotherapy and Oncology, and the Society of Surgical Oncology, the guidelines aim to clarify patient benefits in light of technological advances like image guidance and adaptive radiation therapy. Pancreatic cancer remains a highly lethal disease, with projections suggesting it could become the second leading cause of cancer-related death in the United States by 2030.