Sarma G, Bora H, Medhi PP. Optimizing neoadjuvant chemoradiation in resectable and borderline resectable pancreatic cancer: Evidence-based insights. World J Clin Oncol 2025; 16(7): 106107 [DOI: 10.5306/wjco.v16.i7.106107]
Corresponding Author of This Article
Hima Bora, Researcher, Department of Radiation Oncology, Tezpur Medical College and Hospital, NH-15, Tezpur 784010, Assam, India. himabora36@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Jul 24, 2025; 16(7): 106107 Published online Jul 24, 2025. doi: 10.5306/wjco.v16.i7.106107
Optimizing neoadjuvant chemoradiation in resectable and borderline resectable pancreatic cancer: Evidence-based insights
Gautam Sarma, Hima Bora, Partha P Medhi
Gautam Sarma, Partha P Medhi, Department of Radiation Oncology, All India Institute of Medical Sciences, Guwahati 781101, Assam, India
Hima Bora, Department of Radiation Oncology, Tezpur Medical College and Hospital, Tezpur 784010, Assam, India
Author contributions: Sarma G intellectual content definition; Bora H performed data collection and manuscript editing, literature search, and drafted the manuscript; Sarma G and Medhi PP performed manuscript review and final approval; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hima Bora, Researcher, Department of Radiation Oncology, Tezpur Medical College and Hospital, NH-15, Tezpur 784010, Assam, India. himabora36@gmail.com
Received: February 17, 2025 Revised: April 16, 2025 Accepted: June 3, 2025 Published online: July 24, 2025 Processing time: 155 Days and 17.8 Hours
Abstract
Since its inception, localized pancreatic cancer has been identified as a systemic illness. Hence, to increase its survival rates, surgical resection followed by adjuvant chemotherapy is used as a treatment option. A significant barrier, though, is the high morbidity and drawn-out recovery after extensive surgical resection, which may postpone or prohibit the prompt administration of adjuvant therapy. Thereby, acknowledging the efficacy of neoadjuvant therapy in various digestive tract malignancies like rectal, gastric, and oesophagal cancers in enhancing long-term survival and the likelihood of successful resection, researchers have turned their attention to exploring its potential benefits in the context of both resectable and borderline resectable pancreatic cancer (RPC). According to recent data, neoadjuvant chemoradiation has major advantages for both resectable and borderline RPC. These advantages include increased surgical resection rates, longer survival times, decreased recurrence rates, and better overall disease control with a manageable toxicity profile. Despite its benefits, research is still being done to determine the best way to sequence and combine chemotherapy and radiation. Furthermore, studies have demonstrated the potential for customized therapy regimens based on the patient’s general health status and the tumor’s biological behavior to maximize the neoadjuvant approach. As progress continues, neoadjuvant chemoradiation is set to become a key component of treatment for both resectable and borderline RPC, providing a more efficient way to manage this deadly condition. While further development is required to fully grasp its potential in enhancing long-term patient outcomes, evidence supports its increasing usage in clinical practice.
Core Tip: Recognized from its inception as a systemic disease, localized pancreatic cancer is currently treated with adjuvant chemotherapy and surgical excision to improve survival rates. However, the main obstacle that may postpone or prevent the prompt delivery of adjuvant therapy is the high morbidity and delayed recovery that follows large surgical excision. Thus, acknowledging the potential of neoadjuvant chemoradiation in improving long-term survival and the chance of successful resection for a variety of digestive tract cancers, such as rectal, gastric, and oesophagal cancers, researchers have focused on investigating its potential benefits in the context of both resectable and borderline resectable pancreatic cancer.
