The Controversial Role of Chemoradiation for Patients With Locally Advanced Pancreatic Cancer

Abstract

Abstract Presentation of the Case A 58-year-old woman presents with 2 months of back discomfort. Abdominal computed tomography reveals a 5-cm mass in the body of the pancreas with no obvious metastatic disease. The tumor surrounds the celiac artery, and the superior mesenteric vein is obliterated. Endoscopic ultrasound-guided fine needle aspiration shows adenocarcinoma, positive cytokeratin 7, positive carbohydrate antigen 19–9, and negative cytokeratin 20. She receives 4 months of FOLFIRINOX, with resolution of symptoms and a reduction in the size of the tumor, but the tumor continues to demonstrate superior mesenteric artery encasement and superior mesenteric vein obliteration. Should this patient continue chemotherapy or initiate chemoradiation at this juncture?