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23

NCCN Guidelines for Patients

®

:

Pancreatic Cancer, Version 1.2017

3

Cancer treatments

Radiation therapy

External radiation

For pancreatic cancer, radiation is often given using

a machine outside the body. This method is called

EBRT (

e

xternal

b

eam

r

adiation

t

herapy). For EBRT,

your doctors will first take pictures of the tumor with

a CT scan using contrast dye. This process is called

simulation. Your doctors will use the pictures to help

target the tumor and plan radiation treatment.

Using the CT scan pictures, your doctors will plan

the radiation dose, number and shape of radiation

beams, and number of treatment sessions. Beams

are shaped with computer software and hardware

added to the radiation machine.

During treatment, you will lie on a table in the same

position as done during simulation. Devices may be

used to keep you from moving so that the radiation

targets the tumor. Likewise, methods may be applied

to control breathing. Radiation beams are aimed at

the tumor with help from ink marks on the skin or tiny

gold seeds placed in the tumor.

You will be alone while the technician operates the

machine from a nearby room. He or she will be able

to see, hear, and speak with you at all times. As

treatment is given, you may hear noises. A treatment

session can take about 30 to 60 minutes. The types

of EBRT used for pancreatic cancer include:

†

†

3D-CRT (three-

d

imensional

c

onformal

r

adiation

t

herapy) is given in small doses for a few

weeks with beams that match the shape of the

tumor.

†

†

IMRT (

i

ntensity-

m

odulated

r

adiation

t

herapy)

is given in small doses for a few weeks with

beams of different strengths based on the

thickness of the tumor.

†

†

SBRT (

s

tereotactic

b

ody

r

adiation

t

herapy)

is given in higher doses over a few visits, and

precisely targets the tumor.

Order of treatments

Most people with pancreatic cancer will

receive more than one type of treatment.

When and why treatments are given can

be hard to understand. Part 5 gives more

details. Here, the terms that describe the

order of treatments are explained.

Neoadjuvant treatment

is given to shrink

the tumor before surgery.

Adjuvant treatment

is given after primary

treatment to kill any remaining cancer cells.

Primary treatment

is the main treatment

given to rid the body of cancer.

First-line treatment

is the first set of

treatments given.

Second-line treatment

is the next set of

treatments given after the first or previous

treatments failed.