Comparison of toxicity after IMRT and 3D-conformal radiotherapy for patients with pancreatic cancer – A systematic review

Bittner, Martin-Immanuel; Grosu, Anca‐Ligia; Brunner, Thomas

doi:10.1016/j.radonc.2014.11.043

Cited by 76 publications

(47 citation statements)

References 37 publications

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“…The radiotherapy dose refers to radiotherapy delivered to the tumor during treatment and not to the biologically effective dose. For an estimation of the median radiotherapy dose, the cohort was capped at 64.0 Gy because higher values for EBRT, SBRT, or IMRT were not reported in the literature and were deemed to be clinically improbable . Radiotherapy fractions were recorded as the number of sessions administered during the first course of treatment.…”

Section: Methodsmentioning

confidence: 99%

Stereotactic body radiotherapy for unresected pancreatic cancer: A nationwide review

Geus

Eskander

Kasumova

et al. 2017

Cancer

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Section: Methodsmentioning

confidence: 99%

Stereotactic body radiotherapy for unresected pancreatic cancer: A nationwide review

Geus

Eskander

Kasumova

et al. 2017

Cancer

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“…In a systematic review, authors compared treatment-related toxicities from IMRT and 3D trials. Although no substantial difference in survival was observed between the two treatment techniques, significantly lower grade 3 and higher acute and late toxicities for IMRT have been reported [32]. Due to limited tolerance of adjacent normal structures such as the small bowel and the stomach, the standard radiation dose in the treatment of pancreatic cancer was limited to 50.4 Gy.…”

Section: New Concepts: Intensity-modulated Radiation Therapy Image Gmentioning

confidence: 99%

Integrating radiation oncology into the management of pancreatic cancer

et al. 2019

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Although some improvements have been made in recent years, the prognosis of pancreatic ductal adenocarcinoma remains poor. Surgical resection followed by adjuvant systemic therapy is the only curative treatment option in early stage disease. The role of radiotherapy in the treatment of pancreatic cancer is not well defined and still controversially discussed. Following the results of the ESPAC-1 trial, adjuvant radiochemotherapy (RCT) was no longer employed in most European countries. Nevertheless, in high-risk situations for local recurrence, the addition of adjuvant radiochemotherapy to adjuvant systemic therapy should be discussed, as it may lead to prolonged local tumor control. In resectable tumors, neoadjuvant radiochemotherapy or stereotactic body radiation therapy combined with systemic therapy showed encouraging results in phase I/II trials without increasing postoperative morbidity. Until the results of prospective randomized trials are available, neoadjuvant therapy in resectable pancreatic cancer is only recommended in clinical trials. In borderline resectable and locally advanced tumors, the addition of radiochemotherapy to systemic therapy leads to improved tumor response, and 20-30% of locally advanced tumors can be resected after neoadjuvant therapy. In locally advanced tumors with stable disease after systemic therapy, the addition of radiochemotherapy should be discussed to increase local control and prolong time to local progression. Modern radiotherapy with image guidance, intensitymodulated radiotherapy, and stereotactic body radiotherapy offer new perspectives for the future and will

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“…In a systematic review by Bittner et al . (25), the authors collated treatment-related toxicities from 13 IMRT studies and seven 3D-CRT studies. Although no substantial difference in survival was observed between the two treatment techniques, the authors reported Grade 3 or higher acute gastrointestinal toxicities were significantly lower in those who had IMRT (7.8% vs .…”

Section: Intensity Modulated Radiation Therapy (Imrt) For Lapc (Table 3)mentioning

confidence: 99%

Current and emerging radiotherapy strategies for pancreatic adenocarcinoma: stereotactic, intensity modulated and particle radiotherapy

Ng¹,

Koay²

2018

Ann Pancreat Cancer

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The role of radiotherapy for locally advanced pancreatic cancer (LAPC) is unclear based on studies that used conventional doses and fractionation schedules. Modern radiotherapy techniques have not been studied in depth, however. We reviewed the literature on emerging methods of delivering higher doses of conformal radiotherapy using stereotactic body radiation, intensity modulated radiation, and particle beam radiation, highlighting clinical outcomes and toxicities. The literature review suggests low rates of acute and late toxicities when higher doses of radiation are given with careful attention to normal tissue dose constraints, including for stereotactic body radiotherapy (SBRT), escalated doses with intensity modulated radiation therapy (IMRT), and particle-based therapy. Retrospective evidence suggests prolonged survival for patients who receive biological equivalent doses above 70 Gy. Prospective trials that evaluate modern radiotherapy techniques are warranted for LAPC.

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Comparison of toxicity after IMRT and 3D-conformal radiotherapy for patients with pancreatic cancer – A systematic review

Cited by 76 publications

References 37 publications

Stereotactic body radiotherapy for unresected pancreatic cancer: A nationwide review

Stereotactic body radiotherapy for unresected pancreatic cancer: A nationwide review

Integrating radiation oncology into the management of pancreatic cancer

Current and emerging radiotherapy strategies for pancreatic adenocarcinoma: stereotactic, intensity modulated and particle radiotherapy

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