Physician-researchers from Miami Cancer Institute, part of Baptist Health South Florida, contributed to new international guidelines focused on radiation therapy target volumes and dosing strategies for pancreatic cancer. The guidelines were recently published in the International Journal of Radiation Oncology, Biology, Physics (Red Journal).

“These expert guidelines will provide critical guidance to the radiation oncology community for how to employ more effective target volumes and higher dosing strategies for patients with locally advanced pancreatic tumors, which currently are not routine at most institutions,” said Michael D. Chuong, M.D., vice chair and medical director in the department of radiation oncology at Miami Cancer Institute as well as co-author of the article. “We have published data showing that this novel approach decreases the probability of tumor recurrence after radiation therapy and may contribute to prolonging patient survival.  This was an intensely collaborative effort, and research published on this topic at Miami Cancer Institute where volume- and dose-escalated radiation therapy has been a standard of care since 2018 for locally advanced pancreatic cancer influenced the development of the guidelines. It speaks to the quality of the procedures and research conducted in our department and at our institute.”

Pancreatic cancers are notoriously difficult to treat as symptoms usually present when the cancer is in an advanced stage, and surgery may not be possible. Dose- and volume-escalated radiation therapy is increasingly being used to treat advanced pancreatic cancer, although the optimal technique has not been clearly defined. To facilitate standardization, an expert international panel including radiation oncologists, surgeons, and diagnostic radiologists was recruited. Participants independently contoured high and low risk clinical target volumes on three cases: a borderline resectable head tumor, a locally advanced head tumor, and a medically inoperable tail tumor. After group review and discussion, consensus guidelines were finalized.

“These guidelines reflect an evolution in how radiation therapy is delivered for pancreatic cancer,” said Chuong. “It is our hope that they will fill an unmet need by standardizing practice for both clinical trials and routine practice as more centers begin to offer dose- and volume-escalated radiation therapy for unresectable pancreatic cancers around the world.”

The project was led by researchers at The University of Texas Southwestern Medical Center, with contributions from other centers across the U.S. and the Netherlands, including Miami Cancer Institute.