Follow-up/Toxicity

Question 1

What are the expected acute and late RT toxicities associated with Tx of resected and unresectable PCA?

Answer 1

Acute toxicities: nausea, diarrhea, small bowel obstruction, weight loss, anorexia, abdominal pain

Late toxicities: small bowel obstruction/stenosis/perforation, gastric/small bowel ulceration and/or bleeding, biliary stenosis obstruction, 2nd malignancies

Question 2

What are duodenal toxicities related to fractionated RT or SBRT for PCA?

Answer 2

RT can induce duodenal injury: ulceration, bleeding, perforation, and fistula formation. These mostly occur in the 1st 12 mos after completing RT.

Question 3

What is the typical f/u schedule after Tx of pancreatic cancer?

Answer 3

Pancreatic cancer f/u schedule after Tx: surveillance q3–6mos × 2 yrs, then q6–12mos. At each visit, perform full H&P for Sx assessment, and consider CA 19-9 levels, LFTs, and abdominal CT with contrast.