Pancreatic Cancer Treatment in Istanbul
Pancreatic ductal adenocarcinoma (PDAC) — one of the most challenging cancers — is treated at Istanbul JCI centers with surgery (Whipple), FOLFIRINOX, gemcitabine + nab-paclitaxel, stereotactic MR-Linac SBRT, and HIPEC for peritoneal disease.
Resectable Disease (15-20%)
Pancreaticoduodenectomy (Whipple procedure) or distal pancreatectomy. Adjuvant modified FOLFIRINOX (mFOLFIRINOX) — 6 months. Surgery center: $15,000-25,000 Istanbul.
Borderline/Locally Advanced
Neoadjuvant FOLFIRINOX × 4-6 cycles → reassess resectability. MR-Linac SBRT (5 fractions) to convert unresectable → resectable. Ablative SBRT 50-67.5 Gy in 3-5 fractions.
Metastatic Disease
FOLFIRINOX (ECOG 0-1) or gemcitabine + nab-paclitaxel (ECOG 0-2). KRAS G12C/G12D: emerging targets. BRCA1/2: olaparib maintenance (POLO trial). MSI-H: pembrolizumab.
MR-Linac online adaptive SBRT tracks pancreatic tumor motion in real-time — superior dose delivery with less toxicity. Available at select Istanbul centers.