Published online Feb 15, 2016. doi: 10.4251/wjgo.v8.i2.186
Peer-review started: July 9, 2015
First decision: September 18, 2015
Revised: October 12, 2015
Accepted: December 9, 2015
Article in press: December 11, 2015
Published online: February 15, 2016
Processing time: 214 Days and 21.7 Hours
Core tip: This review summarizes the current status of neoadjuvant radiation approaches for pancreatic cancer. Neoadjuvant chemoradiation for locally-advanced cases results in secondary resectability in a substantial proportion of patients with consecutively improved overall prognosis. In resectable pancreatic cancer, outstanding results in terms of response, local control and overall survival have been observed in several phase I/II trials. Further investigation of neoadjuvant chemoradiation strategies should be performed preferentially in randomized trials and included evaluation of optimal sequencing with chemotherapy and patient selection based on molecular markers. Modern radiation techniques widen the therapeutic window and contribute to the reduction of toxicity.