The guideline strongly recommends that patients who undergo radiation treatments for pancreatic cancer be given prophylactic anti-nausea medicines. It also conditionally recommends the use of antacid or acid-reducing medications.

Dr. Palta explained how these medications are used preventatively with radiation: "If we know that certain side effects tend to occur with a relatively modest or high frequency – such as nausea and stomach pain – there are medications we can give to patients prior to treatment to help mitigate those side effects."


Future Directions

The guideline comments on emerging and upcoming trial reports that will add to the evidence on stereotactic radiation and other aspects of pancreatic cancer treatment, and which subsequently will shape future clinical practice and guideline updates.

"Any patient who is diagnosed with pancreatic cancer deserves to have a multidisciplinary evaluation, where she or he can have nuanced conversations about the benefits and risks of different types of treatment based on the most current information available. It's also essential that any patient who might be an appropriate candidate for radiation have access to a radiation oncologist who can provide perspective on the pros and cons of treatment, so that the patient can make an informed decision," said Dr. Palta. "This is a rapidly evolving field and some potentially practice-changing studies that are not included in this guideline may become available in the relatively near-term future."

About the Guideline

The guideline was based on a systematic literature review of 179 articles published from May 2007 through January 2017. The 14-member task force included a multidisciplinary team of radiation oncologists from a variety of practice settings, a medical physicist, a medical oncologist, a surgical oncologist, a radiation oncology resident and a patient representative. The guideline was developed in collaboration with the American Society of Clinical Oncology (ASCO) and the Society of Surgical Oncology (SSO), who provided representatives and peer reviewers.

ASTRO's clinical guidelines are intended as a tool to promote appropriately individualized, shared decision-making between physicians and patients. None should be construed as strict or superseding the appropriately informed and considered judgments of individual physicians and patients.

"Radiation Therapy for Pancreatic Cancer: An ASTRO Clinical Practice Guideline" is available as a free access article in Practical Radiation Oncology, ASTRO's clinical practice journal. For a copy of the guideline or to interview the task force chairs or outside experts in pancreatic cancer, contact ASTRO's media relations team at press@astro.org or 703-286-1600.

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