Lindsay Romak, M.D., Helps Shape National Guideline for Pancreatic Cancer Treatment

Lindsay Romak, M.D., a radiation oncologist at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute, is a co-author of a newly updated national clinical practice guideline on radiation therapy for pancreatic cancer from the American Society for Radiation Oncology (ASTRO). The guideline provides evidence-based recommendations to help physicians determine when and how radiation therapy should be used for adults with pancreatic cancer.

Published in Practical Radiation Oncology, the updated guideline reflects new clinical evidence and advances in radiation technology since ASTRO’s previous recommendations were issued in 2019. The recommendations address the use of radiation therapy across the spectrum of pancreatic cancer care, including resectable, locally advanced, recurrent, metastatic and palliative settings.

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“National guidelines help translate scientific evidence into better patient care,” said Adam Raben, M.D., chair of Radiation Oncology at the Graham Cancer Center. “Dr. Romak’s contributions to these recommendations reflect ChristianaCare’s leadership in radiation oncology and our commitment to ensuring patients with pancreatic cancer benefit from the latest advances in treatment.”

Bringing Clarity to Complex Treatment Decisions

Pancreatic cancer remains one of the deadliest cancers, with only about one in five patients eligible for surgery at the time of diagnosis. Because treatment decisions often depend on how far the disease has progressed and how patients respond to chemotherapy, determining the role of radiation therapy can be complex. The updated guideline helps multidisciplinary cancer teams make more informed, evidence-based decisions for individual patients.

“These advances are expanding options for patients and allowing us to deliver care more safely and effectively.”—Lindsay Romak, M.D.

“The treatment landscape for pancreatic cancer continues to evolve, and these guidelines help bring greater clarity to difficult treatment decisions,” Romak said. “By incorporating the latest evidence, we can better identify patients who may benefit from radiation therapy and ensure care is tailored to each patient’s unique circumstances.”

The updated recommendations clarify the role of radiation therapy in improving local tumor control, helping some patients become candidates for surgery and relieving symptoms such as pain or bleeding. The guideline also provides new recommendations for recurrent disease, reirradiation and selected patients with oligometastatic or oligoprogressive disease.

Reflecting Advances in Precision Cancer Care

The guideline also recognizes significant advances in radiation treatment technology, including image guidance, motion management and adaptive radiation therapy, which enable physicians to deliver treatment with greater precision while minimizing exposure to nearby healthy tissues.

The updated recommendations will help some patients become candidates for surgery and relieve symptoms such as pain or bleeding.

“At ChristianaCare, we are seeing firsthand how innovations such as adaptive radiation therapy can help us personalize treatment and improve precision,” Romak said. “These advances are expanding options for patients and allowing us to deliver care more safely and effectively.”

Advancing Care in Delaware and Beyond

ASTRO developed the guideline in collaboration with the American Society of Clinical Oncology, the European Society for Radiotherapy and Oncology, and the Society of Surgical Oncology.

For Romak, participating in the effort was an opportunity to help shape national standards for a disease that remains among the most challenging cancers to treat.

“It was an honor to work alongside experts from around the world and across the country on these recommendations,” Romak said. “Our shared goal was to provide clear, evidence-based guidance that helps clinicians deliver the highest quality care and ultimately improves outcomes for patients with pancreatic cancer.”