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

Ng, Sweet Ping; Koay, Eugene J.

doi:10.21037/apc.2018.07.03

Cited by 14 publications

(9 citation statements)

References 34 publications

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“…As many as 40% of pancreatic cancer patients are diagnosed with locoregionally advanced disease or progress during the course of the disease [154]. The infiltration of nerves in the area surrounding the pancreas is observed in 43–72% of patients, which causes severe pain [155]. Delivering median 28 Gy (25–33 Gy) in 5 fractions using SBRT resulted in abdominal pain relief in 78% of advanced pancreatic cancer patients [156].…”

Section: Radiation Therapy For Painful Primary/regional/metastaticmentioning

confidence: 99%

Personalized Radiation Therapy in Cancer Pain Management

Sierko

Hempel

Zuzda

et al. 2019

Cancers

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The majority of advanced cancer patients suffer from pain, which severely deteriorates their quality of life. Apart from analgesics, bisphosphonates, and invasive methods of analgesic treatment (e.g., intraspinal and epidural analgesics or neurolytic blockades), radiation therapy plays an important role in pain alleviation. It is delivered to a growing primary tumour, lymph nodes, or distant metastatic sites, producing pain of various intensity. Currently, different regiments of radiation therapy methods and techniques and various radiation dose fractionations are incorporated into the clinical practice. These include palliative radiation therapy, conventional external beam radiation therapy, as well as modern techniques of intensity modulated radiation therapy, volumetrically modulated arch therapy, stereotactic radiosurgery or stereotactic body radiation therapy, and brachytherapy or radionuclide treatment (e.g., radium-223, strontium-89 for multiple painful osseous metastases). The review describes the possibilities and effectiveness of individual patient-tailored conventional and innovative radiation therapy approaches aiming at pain relief in cancer patients.

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Section: Radiation Therapy For Painful Primary/regional/metastaticmentioning

confidence: 99%

Personalized Radiation Therapy in Cancer Pain Management

Sierko

Hempel

Zuzda

et al. 2019

Cancers

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“…Numerous authors have confirmed the feasibility and safety of SBRT in pancreatic cancer with standard linacs, achieving 1-year local control of 80% in locally advanced pancreatic cancer (LAPC), even if the first experiences were burdened by high rates of ≥3 grade gastrointestinal toxicity, representing a significant dose limiting factor [25–30].…”

Section: Introductionmentioning

confidence: 99%

“…respiratory gating) and Image Guided Radiotherapy (IGRT) techniques (i.e. CBCT, CT-on-rails) contributed in reducing gastrointestinal side effects and escalating the dose to the target volumes, reaching higher biological equivalent doses [25, 31].…”

Section: Introductionmentioning

confidence: 99%

Online adaptive magnetic resonance guided radiotherapy for pancreatic cancer: state of the art, pearls and pitfalls

et al. 2019

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Background Different studies have proved in recent years that hypofractionated radiotherapy (RT) improves overall survival of patients affected by locally advanced, unresectable, pancreatic cancer. The clinical management of these patients generally leads to poor results and is considered very challenging, due to different factors, heavily influencing treatment delivery and its outcomes. Firstly, the dose prescribed to the target is limited by the toxicity that the highly radio-sensitive organs at risk (OARs) surrounding the disease can develop. Treatment delivery is also complicated by the significant inter-fractional and intra-fractional variability of therapy volumes, mainly related to the presence of hollow organs and to the breathing cycle. Main body of the abstract The recent introduction of magnetic resonance guided radiotherapy (MRgRT) systems leads to the opportunity to control most of the aforementioned sources of uncertainty influencing RT treatment workflow in pancreatic cancer. MRgRT offers the possibility to accurately identify radiotherapy volumes, thanks to the high soft-tissue contrast provided by the Magnetic Resonance imaging (MRI), and to monitor the tumour and OARs positions during the treatment fraction using a high-temporal cine MRI. However, the main advantage offered by the MRgRT is the possibility to online adapt the RT treatment plan, changing the dose distribution while the patient is still on couch and successfully addressing most of the sources of variability. Short conclusion Aim of this study is to present and discuss the state of the art, the main pitfalls and the innovative opportunities offered by online adaptive MRgRT in pancreatic cancer treatment.

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“…The recent focus of neoadjuvant treatment strategies for LAPC lies in investigating more effective chemotherapy schemes, such as FOLFIRINOX (leucovorin, 5-fluorouracil, irinotecan, and oxaliplatin) [ 13 , 14 , 15 , 16 , 17 ], and subsequent CRT or RT with modern techniques (e.g., stereotactic, intensity modulated, and particle RT) [ 18 ]. The high failure rate of RT in PDAC can be attributed to the high intrinsic radioresistance of the tumors [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The Emerging Role of miRNAs for the Radiation Treatment of Pancreatic Cancer

Nguyen

Schilling

Dobiasch

et al. 2020

Cancers

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Today, pancreatic cancer is the seventh leading cause of cancer-related deaths worldwide with a five-year overall survival rate of less than 7%. Only 15–20% of patients are eligible for curative intent surgery at the time of diagnosis. Therefore, neoadjuvant treatment regimens have been introduced in order to downsize the tumor by chemotherapy and radiotherapy. To further increase the efficacy of radiotherapy, novel molecular biomarkers are urgently needed to define the subgroup of pancreatic cancer patients who would benefit most from radiotherapy. MicroRNAs (miRNAs) could have the potential to serve as novel predictive and prognostic biomarkers in patients with pancreatic cancer. In the present article, the role of miRNAs as blood biomarkers, which are associated with either radioresistance or radiation-induced changes of miRNAs in pancreatic cancer, is discussed. Furthermore, the manuscript provides own data of miRNAs identified in a pancreatic cancer mouse model as well as radiation-induced miRNA changes in the plasma of tumor-bearing mice.

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

Cited by 14 publications

References 34 publications

Personalized Radiation Therapy in Cancer Pain Management

Personalized Radiation Therapy in Cancer Pain Management

Online adaptive magnetic resonance guided radiotherapy for pancreatic cancer: state of the art, pearls and pitfalls

The Emerging Role of miRNAs for the Radiation Treatment of Pancreatic Cancer

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