Radiotherapy in the management of pancreatic neuroendocrine tumors (PNET): experience at three institutions.
AIM
Advanced pancreatic neuroendocrine tumor (PNET) presents a therapeutic challenge as many are unresectable and relatively resistant to systemic therapy with a high malignant potential. We share our experience using concurrent capecitabine or infusional 5-fluorouracil with radiation for patients with resected and locally advanced PNET.


PATIENTS AND METHODS
Six patients (two females, four males) with PNET were treated with capecitabine or infusional 5-FU and concurrent radiation.


RESULTS
The median age was 52 years (range: 38 to 63 years), with ECOG Performance Status (PS) 0-1, grade 0-1 weight loss, and grade 0-1 pain. One patient underwent resection with negative margins, two with positive margins, and three had unresectable locally advanced disease. All six patients demonstrated partial radiographic response and sustained local control. The treatment was tolerable with only grade 2 hand-foot syndrome and grade 1 mucositis observed.


CONCLUSION
Prospective studies to further investigate the role of chemoradiation in this setting are warranted.