Utilization of Intensity-Modulated Radiation Therapy and Image-Guided Radiation Therapy in Pancreatic Cancer: Is It Beneficial?

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

“…To our best knowledge, we present the first review systematically analysing a representative number of studies employing IMRT for the treatment of pancreatic cancer, and comparing them to well accepted standard-of-care studies employing conventional 3D-CRT. In addition to the data presented in a recent analysis by Reese et al [27], we calculated integrated toxicity incidences, which we deem especially valuable from a clinical point of view. The comparison with the afore-mentioned work also allows us to state that the studies identified by us show no evident misses.…”

Quantification of MRI visibility and artifacts at 3T of liquid fiducial marker in a pancreas tissue‐mimicking phantom

“…As the pancreas shows considerable intra‐ and interfractional motion and deformation, image‐guided radiotherapy (IGRT) is used to accurately position the patient and localize the tumor prior to each treatment fraction. Hence, the setup uncertainties and treatment margins can potentially be reduced, which results in an improved sparing of surrounding healthy tissues without compromising dose coverage of the target volume . IGRT of PDAC based on implanted fiducial markers and daily orthogonal kV imaging or cone‐beam computed tomography (CBCT) has been shown to significantly reduce the setup error as compared to bony alignment…”

“…Hence, the setup uncertainties and treatment margins can potentially be reduced, which results in an improved sparing of surrounding healthy tissues without compromising dose coverage of the target volume. 3 IGRT of PDAC based on implanted fiducial markers and daily orthogonal kV imaging or cone-beam computed tomography (CBCT) has been shown to significantly reduce the setup error as compared to bony alignment. 4 Delineation of PDAC based on CT images was found to result in large interobserver variations due to poor soft-tissue contrast.…”

Pancreatic Cancer

“…242 Four-dimensional (4D) CT may underestimate motion compared to fluoroscopy, ultrasound, and MRI. Reese et al summarized several studies that described a large range of potential respiratory motion from 5 mm to 43 mm, indicating the need for individualized margins.…”