Dose escalation with external beam radiation therapy in pancreatic cancer. State of the art.

Abstract

Pancreatic cancer is a disease where most of the patients are in unresectable stages since its diagnosis. Radiotherapy and chemotherapy have proven to be an important part of the treatment of patients with pancreatic cancer. With the advent of new radiotherapy techniques it has been possible to increase the dose directed to the lesion, respecting the tolerances of the organs adjacent to the lesion. It has been described that increasing the radiation dose per fraction in turn increases the biologically effective dose (BED), allowing the treatment to be carried out in less time and at the same time scaling the total dose received by the patient. This is the basis of hypofractionation and stereotactic radiotherapy which have an increasing role in the treatment of this group of patients due to the better response of this type of tumors with increasing radiation dose. The development of a narrative review on dose escalation with external beam radiation therapy in pancreatic cancer, allows us to know the techniques and fractionations that are being used, motivating the development and use of these tools for the benefit of the patient in our country.