Stereotactic body radiation therapy for reirradiation of localized adenocarcinoma of the pancreas

Abstract

BackgroundLocal control rates are poor in the treatment of pancreatic cancer. We investigated the role of hypofractionated stereotactic body radiation therapy (SBRT) for salvage or boost treatment after conventional doses of external beam radiation therapy.MethodsAll patients treated with SBRT for pancreatic adenocarcinoma at Georgetown University from June 2002 through July 2007 were examined. Eligible patients had prior external beam radiation therapy to the pancreas. Treatment parameters and clinical and radiographic follow-up were evaluated.ResultsTwenty-eight patients were identified who received SBRT after a median prior external beam radiotherapy dose of 50.4 Gy. The median patient age was 63 years old and the median follow-up was 5.9 months. Twelve of fourteen (85.7%) evaluable patients were free from local progression, with three partial responses and nine patients with stable disease. Toxicity consisted of one case of acute Grade II nausea/vomiting, and two cases of Grade III late GI toxicity. The median overall survival was 5.9 months, with 18% survival and 70% freedom from local progression at one year.ConclusionsHypofractionated SBRT reirradiation of localized pancreatic cancer is a well-tolerated treatment. Most patients are free from local progression, albeit with limited follow-up, but overall survival remains poor.

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

“…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.…”

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.…”

Feasibility and reproducibility of substituting oral contrast with water for duodenal volume delineation in patients undergoing pancreatic stereotactic body radiotherapy

“…Feasibility and efficacy has been shown in neoadjuvant settings (14), elderly patients (15), those with many comorbidities (16), and re-irradiation cases (17).…”