膵癌

Pancreatic cancer

膵癌治療における放射線治療の役割は，切除可能膵癌あるいは切除可能境界膵癌に対する術前（あるいは術後）補助療法，切除不能局所進行膵癌に対する根治的照射，そして緩和照射が挙げられる。いずれも重要な役割を担っているが，特に切除不能局所進行例に対する根治的照射としての意義は大きい。しかし，膵癌に対する放射線治療には多くの課題が存在する。

Pancreatic cancer is a dismal disease with poor survival outcome. There have been three randomized controlled trials comparing chemotherapy alone and chemoradiotherapy in the treatment of locally advanced pancreatic cancer since 2000. However, the role of radiotherapy in pancreatic cancer is controversial even now. The radiation dose that can be delivered to pancreatic cancer is limited because there are many radiosensitive organs around the pancreas. Particle therapy may be able to achieve a higher tumor control rate and contribute to survival benefit due to its better dose conformity and higher biological effectiveness than conventional photon therapy. Here we review the current literature and discuss emerging roles of particle therapy in pancreatic cancer treatment.