Dosimetric and clinical predictors of toxicity following combined chemotherapy and moderately hypofractionated rotational radiotherapy of locally advanced pancreatic adenocarcinoma

SBRT in pancreatic cancer: What is the therapeutic window?

“…This is not the only report of severe complications after reirradiation to the pancreas which should only be conducted within clinical trials and extreme caution. A group from Milan reported dosimetric clinical predictors of gastrointestinal toxicity after combined hypofractionated chemoradiotherapy (44.25 Gy in 15 fractions) of pancreatic cancer [9]. The results of multivariate analysis showed that duodenum V 45 and V 40 were significant predictors of Pgrade 2 'anatomical', i.e.…”

“…A recent analysis using this approach showed that acute and late gastrointestinal toxicity was the most important side-effect. Careful analysis showed that dose volume histograms values for the duodenum and the stomach were significantly related to the observed toxicities [9]. One way to reduce the exposure of the stomach and duodenum mucosa the radiation dose is the reduction of planning target volume margins.…”

Dosimetric Advantages of Midventilation Compared With Internal Target Volume for Radiation Therapy of Pancreatic Cancer

“…Several reports have described gastrointestinal toxicity in detail, focusing on the duodenum and stomach, when treating pancreatic cancer with radiation therapy (22)(23)(24)(25). These studies analyzed gastrointestinal toxicity by evaluating V 10Gy to V 50Gy , D 2cc , and D mean of the stomach and duodenum.…”

“…The V 10Gy , V 20Gy , V 30Gy , V 40Gy , D 2cc and the D mean of the stomach and duodenum have been indicated to be strong predictors for gastrointestinal toxicity (22)(23)(24)(25). For each plan, these parameters were determined, as were the V 20Gy and D mean of the kidney closest to the PTV (ipsilateral kidney) and the D max of the spinal cord.…”

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

“…Only surgery offers a potentially curative approach, but most patients present either with metastasis or locally advanced disease precluding resection [1]. Chemoradiotherapy is an important treatment modality in the definitive treatment of locally advanced pancreatic cancer and potentially in the neoadjuvant setting to achieve secondary resectability [2].Nevertheless, chemoradiotherapy of pancreatic cancer often causes toxicities which can lead to considerable loss of quality of life [3]. The importance to adhere to maximum normal tissue doses has been recognized before.…”