Pankreas Kanserinde Radyoterapi
Özet
Pankreas kanseri, derin retroperitoneal yerleşimi ve kritik vasküler yapılara yakınlığı nedeniyle genellikle ileri evrede teşhis edilen, dünya genelinde kansere bağlı ölümlerin en sık yedinci nedenidir. Temel tedavi yöntemi cerrahi rezeksiyon olsa da hastaların yalnızca küçük bir kısmı tanı anında ameliyata uygundur. Bu durum, sağkalımı ve lokal kontrolü artırmak adına kemoterapi ve radyoterapi gibi multidisipliner yaklaşımları zorunlu kılmaktadır. Neoadjuvan tedaviler inoperabl hastaları cerrahiye hazırlamayı amaçlarken, adjuvan radyoterapinin yeri ve optimal dozajı konusundaki tartışmalar devam etmektedir. Son yıllarda, gelişen teknolojiyle birlikte tümöre yüksek doz radyasyon verirken çevre organları koruyan Stereotaktik Vücut Radyoterapisi (SBRT) ve hiperfraksiyone uygulamalar lokal kontrol oranlarında belirgin iyileşme sağlamıştır. Klinik ve patolojik bulguların ışığında her hasta için en uygun tedavi yönetimi multidisipliner bir ekip tarafından kurgulanmalıdır.
Pancreatic cancer is the seventh leading cause of cancer-related deaths worldwide, frequently diagnosed at an advanced stage due to its deep retroperitoneal location and proximity to major vascular structures. Although surgical resection remains the primary curative treatment, only a minority of patients are eligible at diagnosis. This challenge necessitates multidisciplinary approaches, including chemotherapy and radiotherapy, to improve overall survival and local control. While neoadjuvant therapies aim to downstage inoperable tumors for surgery, the role and optimal dosage of adjuvant radiotherapy remain subject to ongoing debate. In recent years, technological advancements have introduced Stereotactic Body Radiotherapy (SBRT) and hyperfractionated regimens, which deliver high radiation doses to the tumor while sparing surrounding critical organs, leading to significantly enhanced local control. Ultimately, optimal treatment strategies must be tailored individually through multidisciplinary consensus.
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