Abstract
The clinical practice guidelines for Pancreatic Cancer 2022 from the Japan Pancreas Society established nine clinical questions (CQ) for the use of radiation therapy. As first-line treatment for patients with locally advanced unresectable pancreatic cancer (LAUPC), chemoradiotherapy or chemotherapy alone is recommended, as in the Clinical Practice Guidelines for Pancreatic Cancer 2019. Induction chemotherapy prior to chemoradiotherapy using gemcitabine hydrochloride alone is not recommended in patients with LAUPC. Two new CQs regarding high-precision radiotherapy (intensity modulated radiotherapy, stereotactic body radiotherapy, and particle therapy) and hyperthermia for LAUPC were adopted. An inncreased radiation dose using high-precision radiotherapy is recommended for patients with LAUPC. In a CQ about the utility of radiotherapy for patients with postoperative metastatic/recurrent pancreatic cancer, radiotherapy is recommended for patients with local recurrence and regional lymph node metastases or lung metastases as in the 2019 version.
