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Chemoradiotherapy Versus Immediate Surgery for Resectable and Borderline Resectable Pancreatic Cancer (PREOPANC-1)25 study shows a significant improvement in R0 resection rate, local recurrence rate, and median disease-free survival with neoadjuvant CRT compared with surgery alone in resectable and borderline resectable disease. However, because prior prospective experience with short-course radiotherapy was limited to resectable disease,16,17 it was unclear if short-course treatment would be adequate in the setting of vascular involvement. We therefore administered long-course radiotherapy in the setting of persistent vascular involvement after 4 months of FOLFIRINOX to potentially enhance the odds of an R0 resection. Local control was achieved in most patients who underwent resection, with 5 patients (15%) relapsing only locally after R0 resection in all but 1 patient. In contrast, our borderline resectable disease study demonstrated a local recurrence rate of 6%
In my opinion, if combined chemo and radiotherapy becomes standard of care prior to resection, then Oncosil's product has every opportunity of filling a need. The dose delivered in oncosil is higher than in conventional EBR.
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