Published online Dec 15, 2021. doi: 10.4251/wjgo.v13.i12.2064
Peer-review started: March 22, 2021
First decision: June 16, 2021
Revised: June 28, 2021
Accepted: October 25, 2021
Article in press: October 25, 2021
Published online: December 15, 2021
Pancreatic cancer is the 7th leading cause of death due to cancer in industrialized countries and the 11th most common cancer globally, with 458918 new cases (2.5% of all cancers) and 432242 deaths (4.5% of all cancer deaths) in 2018. Unfortunately, 80% to 90% of the patients present with unresectable disease, and the reported 5-year survival rate range between 10% and 25%, even after successful resection with tumor-free margins. Systemic chemotherapy, radiotherapy, and minimally invasive image-guided procedures that have emerged over the past years, are used for the management of non-operable PC. This review focuses on currently available non-surgical options of locally advanced pancreatic cancer.
Core Tip: Currently available non-surgical treatment options for locally advanced pancreatic cancer include systemic chemotherapy, radiotherapy, and minimally invasive image-guided procedures. The latter have emerged over the past years and include radiofrequency, microwave ablation, laser ablation, cryoablation, irreversible electroporation, high intensity focused ultrasound, and trans-arterial embolization procedures. Although initial results were not deemed satisfactory, mainly due to unacceptable complication rates, cumulative experience and technological advances have led to the improvement of outcomes of image-guided procedures and their incorporation in the treatment algorithm.