Current status and progress of comprehensive treatment for locally advanced pancreatic cancer

Locally advanced pancreatic cancer (LAPC) involves with adjacent vascular structures, which is divided into the borderline resectable pancreatic cancer (BRPC) and unresectable pancreatic cancer. BRPC is usually treated with vascular restruction.Neoadjuvant therapy plays an important role in achieving an R₀ resection in BRPC. Generally, the goal of treatment for unresectable pancreatic cancer is to control tumor progress and improve patients′ quality of life. The latest cheering clinical trials have shown that some LAPC may be downstaged to resectable tumors after preoperative chemotherapy and chemoradiotherapy. In this article, the rationale for and results following treatment with neoadjuvant chemotherapy, chemoradiation and possibly subsequent surgical resection of the primary tumor are described in detail and existing data are reviewed.