Stereotactic Body Radiation Therapy Boost in Locally Advanced Pancreatic Cancer

Seo, Young Seok; Kim, Mi Sook; Yoo, Seong-Yul; Cho, Chul Koo; Yang, Kyung‐Soo; Yoo, Hyun Jung; Choi, Chul Won; Lee, Dong Han; Kim, Jin; Kim, Min Suk; Kang, Hye Jin; Kim, Young Han

doi:10.1016/j.ijrobp.2009.01.042

Cited by 38 publications

(60 citation statements)

References 26 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Buwenge

Cilla

Guido

et al. 2016

Reports of Practical Oncology & Radiotherapy

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Buwenge

Cilla

Guido

et al. 2016

Reports of Practical Oncology & Radiotherapy

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“…However, the Pittsburgh study did not report outcomes separately for the patients with prior radiation, limiting the conclusions that can be drawn about the use of SBRT in the setting of prior radiation. Seo et al retrospectively reported the largest series after external beam radiotherapy (40 Gy in 20 fractions) as a planned boost [21]. 15–17 Gy was delivered as a single fraction.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2012

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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.

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“…Stereotactic body radiation therapy (SBRT) allows for the delivery of high radiation doses while minimizing toxicity on adjacent organs 1,2. This technique demands high targeting accuracy, taking into account respiratory and other involuntary motion of the target lesion during radiation therapy 2.…”

Section: Introductionmentioning

confidence: 99%

Fiducial Placement for Stereotactic Body Radiation Therapy under Only Endoscopic Ultrasonography Guidance in Pancreatic and Hepatic Malignancy: Practical Feasibility and Safety

Choi¹,

Seo²,

Park³

et al. 2014

Gut Liver

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Background/AimsStereotactic body radiation therapy (SBRT) for gastrointestinal malignancies requires the placement of fiducials to guide treatment delivery. This study aimed to determine the safety and technical feasibility of endoscopic ultrasonography (EUS)-guided fiducial placement for SBRT.MethodsFrom November 2010 to August 2012, 32 consecutive patients who were scheduled to receive SBRT for pancreatic and hepatic malignancies were referred for EUS-guided fiducial placement. Primary outcome measurements included technical success, the fiducial migration rate, and procedural complications.ResultsAll 32 patients had successful fiducial placement under EUS guidance. The mean number of fiducials placed per patient was 2.94±0.24 (range, 2 to 3 seeds). Spontaneous fiducial migration was noted in one patient (3.1%). Of the 32 patients with fiducials placed, 29 patients (90.6%) successfully underwent SBRT. One patient (3.1%) developed mild pancreatitis, requiring a 2-day prolonged hospitalization after fiducial placement. Five patients (15.6%) underwent same-session, EUS-guided fine needle aspiration for histologic confirmation at the time of fiducial placement, without any procedure-related complication.ConclusionsEUS-guided fiducial placement is a safe and technically feasible technique for preparing patients with both pancreatic and hepatic malignancies for SBRT. The fiducial markers facilitate safe and accurate targeting of the tumor during SBRT.

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Stereotactic Body Radiation Therapy Boost in Locally Advanced Pancreatic Cancer

Cited by 38 publications

References 26 publications

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

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

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

Fiducial Placement for Stereotactic Body Radiation Therapy under Only Endoscopic Ultrasonography Guidance in Pancreatic and Hepatic Malignancy: Practical Feasibility and Safety

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