Image-Guided Stereotactic Radiosurgery for Locally Advanced Pancreatic Adenocarcinoma Results of First 85 Patients

Abstract

SRS for unresectable pancreatic carcinoma can be delivered in three fractions with minimal morbidity and a local tumor control rate of 91.7%. The survival is comparable or better than the reported results for advanced pancreatic cancer, specifically for the group of previously untreated patients with unresectable tumors. Development of distant metastases remains a significant factor.

Individually optimized stereotactic radiotherapy for pancreatic head tumors: A planning feasibility study

“…Although in previous studies of stereotactic radiation therapy lower margins (2-4 mm) were used, 4,14,16 we considered that these larger margins were more reasonable and prudent, with the aim of avoiding marginal misses. In fact, based on the results of a study on organ motion in patients with locally advanced adenocarcinoma of the pancreas, margins of GTV to 10 mm, 7 mm, and 6 mm in the cranio-caudal, anterior-posterior and medial-lateral direction were recommended, respectively.…”

“…3 Recently, it has been proposed by some authors to use stereotactic body radiation therapy (SBRT) for the treatment of these tumors. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] The use of stereotactic techniques is theoretically useful to administer high doses of radiation to the tumor with optimum sparing of organs at risk (OARs). Furthermore, SBRT treatment has other advantages and particularly its brevity.…”

MRI quantification of pancreas motion as a function of patient setup for particle therapy —a preliminary study

“…Respiratory gated particle irradiation, in particular, entails the delivery of the planned dose in correspondence of a predefined respiratory gate featuring the highest motion stability and repeatability of the anatomopathological configuration. It has been demonstrated that this technique allows dose escalation in the target and increases the effectiveness in local control of locally advanced pancreas cancer 26 , 27 . Furthermore, respiratory correlated imaging techniques greatly support respiratory motion management (25) .…”

Pancreatic cancer and SBRT: A new potential option?

“…28 Numerous other published trials have also looked at the role of SBRT in the treatment of locally advanced pancreatic cancer. [29][30][31][32][33][34][35][36] In Table 1, we present a selected number of studies addressing this topic.…”