Preoperative chemoradiation in resectable XXXX .

@entity1 @entity788 @entity420 @entity3
Despite advancements in the field of surgical oncology, the diagnosis of @entity788 still carries a grave and dismal prognosis. Surgery alone for @entity420 of the pancreatic head or uncinate process has a median survival time of 12 months. These grim statistics have led many to study the effects of combined multimodality therapy in the fight against @entity788 . The long recovery time associated with pancreaticoduodenectomy has resulted in as many as 25% of @entity1 unable to proceed with planned adjuvant therapy. For these reasons preoperative or neoadjuvantc hemoradiation therapy (CRT) has been evaluated. Pre-operative CRT ensures that all eligible @entity1 receive the benefits of multimodality therapy, and @entity1 who manifest @entity3 on restaging evaluations are spared the morbidity of an unnecessary laparotomy. Multimodality therapy appears to lengthen the survival duration in @entity1 with @entity788 . It also affords a selection advantage, in that @entity1 with aggressive disease biology with advanced @entity3 following CRT are spared the morbidity of surgery. Conversely, a limited subset of @entity1 may even be downstaged, allowing for a potentially curative resection. In this article we review the current status of neoadjuvant chemoradiation in @entity420 . We discuss its rationale in light of the reported strengths and weaknesses of postoperative adjuvant CRT.
