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Pancreas sbrt

Eric A Mellon, William H Jin, Jessica M Frakes, Barbara A Centeno, Tobin J Strom, Gregory M Springett, Mokenge P Malafa, Ravi Shridhar, Pamela J Hodul, Sarah E Hoffe
BACKGROUND: Neoadjuvant therapy response correlates with survival in multiple gastrointestinal malignancies. To potentially augment neoadjuvant response for pancreas adenocarcinoma, we intensified treatment with stereotactic body radiotherapy (SBRT) following multi-agent chemotherapy. Using this regimen, we analyzed whether the College of American Pathology (CAP) tumor regression grade (TRG) at pancreatectomy correlated with established response biomarkers and survival. MATERIALS AND METHODS: We identified borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer patients treated according to our institutional clinical pathway who underwent surgical resection with reported TRG (n = 81, median follow-up after surgery 24...
November 25, 2016: Acta Oncologica
Kristofer Kainz, Douglas Prah, Ergun Ahunbay, X Allen Li
"Burst-mode" modulated arc therapy (hereafter referred to as "mARC") is a form of volumetric-modulated arc therapy characterized by variable gantry rotation speed, static MLCs while the radiation beam is on, and MLC repositioning while the beam is off. We present our clinical experience with the planning techniques and plan quality assurance measurements of mARC delivery. Clinical mARC plans for five representative cases (prostate, low-dose-rate brain, brain with partial-arc vertex fields, pancreas, and liver SBRT) were generated using a Monte Carlo-based treatment planning system...
2016: Journal of Applied Clinical Medical Physics
W Yang, Z Fan, J Pang, Z Deng, X Bi, B A Fraass, H M Sandler, N N Nissen, D Li, R Tuli
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Kamran A Ahmed, Jimmy J Caudell, Ghassan El-Haddad, Anders E Berglund, Eric A Welsh, Binglin Yue, Sarah E Hoffe, Arash O Naghavi, Yazan A Abuodeh, Jessica M Frakes, Steven A Eschrich, Javier F Torres-Roca
PURPOSE/OBJECTIVES: Evidence from the management of oligometastases with stereotactic body radiation therapy (SBRT) reveals differences in outcomes based on primary histology. We have previously identified a multigene expression index for tumor radiosensitivity (RSI) with validation in multiple independent cohorts. In this study, we assessed RSI in liver metastases and assessed our clinical outcomes after SBRT based on primary histology. METHODS AND MATERIALS: Patients were identified from our prospective, observational protocol...
August 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Samuel K Kim, Cheng-Chia Wu, David P Horowitz
With recent advances in imaging modalities and radiation therapy, stereotactic body radiotherapy (SBRT) has allowed for the delivery of high doses of radiation with accuracy and precision. As such, SBRT has generated favorable results in the treatment of several cancers. Although the role of radiation has been controversial for the treatment of pancreatic ductal adenocarcinoma (PDAC) due to rather lackluster results in clinical trials, SBRT may offer improved outcomes, enhance the quality of life, and aid in palliative care settings for PDAC patients...
June 2016: Journal of Gastrointestinal Oncology
Sten Myrehaug, Arjun Sahgal, Suzanne M Russo, Simon S Lo, Lauren M Rosati, Nina A Mayr, Michael Lock, William Small, Jennifer A Dorth, Rodney J Ellis, Bin S Teh, Joseph M Herman
Despite advances in surgical, medical, and radiation therapy for pancreatic cancer, the prognosis remains poor. At this time, the only chance for long-term survival is surgical resection. More challenging is the optimal management of unresectable locally advanced pancreatic cancer, which has historically been treated with concurrent chemoradiation or chemotherapy alone. However, the survival and local control benefit of conventional radiotherapy in addition to chemotherapy was unclear. More recently, stereotactic body radiotherapy (SBRT) is emerging as a viable approach to maximizing local tumor control with a tolerable side effect profile...
May 2016: Expert Review of Anticancer Therapy
Nergiz Dagoglu, Mark Callery, James Moser, Jennifer Tseng, Tara Kent, Andrea Bullock, Rebecca Miksad, Joseph D Mancias, Anand Mahadevan
OBJECTIVES: After adjuvant or definitive radiation for pancreas cancer, there are limited conventional treatment options for recurrent pancreas cancer. We explored the role of (Stereotactic Body Radiotherapy) SBRT for reirradiation of recurrent pancreas Cancer. METHODS: This is a retrospective study of patients reirradiated with SBRT for recurrent pancreas cancer. All patients were deemed unresectable and treated with systemic therapy. Fiducial gold markers were used...
2016: Journal of Cancer
Qichun Wei, Wei Yu, Lauren M Rosati, Joseph M Herman
Pancreatic cancer (PCA) is one of the most aggressive tumors with few effective treatment modalities. It is the 4th and 7th leading cause of cancer death in the United States and China, respectively. At the time of diagnosis, only 20% of cases present with a resectable tumor, and about 40% with a locally advanced tumor that is considered unresectable. Even resected patients still have a poor prognosis, with an incidence of local recurrence ranging from 20% to 60%. It is also reported that up to 30% of PCA patients die from locally obstructive disease with few or no distant metastases...
August 2015: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Yongbao Li, Jeremy D P Hoisak, Nan Li, Carrie Jiang, Zhen Tian, Quentin Gautier, Masoud Zarepisheh, Zhaoxia Wu, Yaqiang Liu, Xun Jia, Jona Hattangadi-Gluth, Loren K Mell, Steve Jiang, James D Murphy
Stereotactic body radiotherapy (SBRT) shows promise in unresectable pancreatic cancer, though this treatment modality has high rates of normal tissue toxicity. This study explores the dosimetric utility of daily adaptive re-planning with pancreas SBRT. We used a previously developed supercomputing online re-planning environment (SCORE) to re-plan 10 patients with pancreas SBRT. Tumor and normal tissue contours were deformed from treatment planning computed tomographies (CTs) and transferred to daily cone-beam CT (CBCT) scans before re-optimizing each daily treatment plan...
2015: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Zhi-Yong Yuan, Mao-Bin Meng, Chun-Lei Liu, Huan-Huan Wang, Chao Jiang, Yong-Chun Song, Hong-Qing Zhuang, Dong Yang, Jing-Sheng Wang, Wang Wei, Feng-Tong Li, Lu-Jun Zhao, Ping Wang
The aim of this study was to evaluate the efficacy and toxicity of stereotactic body radiation therapy (SBRT) in the treatment of patients with liver metastases. Between August 2006 and July 2011, patients with 1-4 liver metastases were enrolled and treated with SBRT using the CyberKnife(®) system at Tianjin Medical University Cancer Institute and Hospital. The metastases were from different primary tumors, with a maximum tumor diameter of less than 6 cm. The primary endpoint was local control. Secondary endpoints were overall survival, progression-free survival, distant progression-free survival, and adverse events...
2014: OncoTargets and Therapy
Wensha Yang, Benedick A Fraass, Robert Reznik, Nicholas Nissen, Simon Lo, Laith H Jamil, Kapil Gupta, Howard Sandler, Richard Tuli
PURPOSE: To evaluate use of breath-hold CTs and implanted fiducials for definition of the internal target volume (ITV) margin for upper abdominal stereotactic body radiation therapy (SBRT). To study the statistics of inter- and intra-fractional motion information. METHODS AND MATERIALS: 11 patients treated with SBRT for locally advanced pancreatic cancer (LAPC) or liver cancer were included in the study. Patients underwent fiducial implantation, free-breathing CT and breath-hold CTs at end inhalation/exhalation...
January 9, 2014: Radiation Oncology
Joanne N Davis, Clinton Medbery, Sanjeev Sharma, Adnan Danish, Anand Mahadevan
BACKGROUND: The RSSearch™ Registry is a multi-institutional, observational, ongoing registry established to standardize data collection from patients treated with stereotactic radiosurgery (SRS) and/or stereotactic body radiotherapy (SBRT). This report describes the design, patient demographics, lesion characteristics, and SRS/SBRT treatment patterns in RSSearch™. Illustrative patient-related outcomes are also presented for two common treatment sites--brain metastases and liver metastases...
2013: Radiation Oncology
Akash Bijlani, Giovanni Aguzzi, David W Schaal, Pantaleo Romanelli
OBJECTIVE: To describe and synthesize the current stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) cost-effectiveness research to date across several common SRS and SBRT applications. METHODS: This review was limited to comparative economic evaluations of SRS, SBRT, and alternative treatments (e.g., other radiotherapy techniques or surgery). Based on PubMed searches using the terms, "stereotactic," "SRS," "stereotactic radiotherapy," "stereotactic body radiotherapy," "SBRT," "stereotactic ablative radiotherapy," "economic evaluation," "quality adjusted life year (QALY)," "cost," "cost-effectiveness," "cost-utility," and "cost analysis," published studies of cost-effectiveness and health economics were obtained...
2013: Frontiers in Oncology
Jiajia Ge, Lakshmi Santanam, Camille Noel, Parag J Parikh
PURPOSE: To evaluate whether planning 4-dimensional computed tomography (4DCT) can adequately represent daily motion of abdominal tumors in regularly fractionated and stereotactic body radiation therapy (SBRT) patients. METHODS AND MATERIALS: Intrafractional tumor motion of 10 patients with abdominal tumors (4 pancreas-fractionated and 6 liver-stereotactic patients) with implanted fiducials was measured based on daily orthogonal fluoroscopic movies over 38 treatment fractions...
March 15, 2013: International Journal of Radiation Oncology, Biology, Physics
Charles L Perkins, Bassel El-Reyes, Edmund Simon, David Kooby, William Torres, John S Kauh, Charles A Staley, Jerome C Landry
PURPOSE: Extracranial radiosurgery (ECRS) is a novel treatment for inoperable recurrent or metastatic abdominopelvic cancers. However, local control, metabolic response, and acute toxicity remain undefined. We therefore analyzed these endpoints in patients treated with single-fraction image-guided ECRS at Emory University. METHODS: 20 patients with recurrent or metastatic inoperable abdominal or pelvic cancers (23 sites) were treated with single-fraction ECRS using a Varian linear accelerator between 08/2006 and 02/2008...
September 2010: Journal of Gastrointestinal Oncology
Chris E Lominska, Keith Unger, Nadim M Nasr, Nadim Haddad, Greg Gagnon
BACKGROUND: Local 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. METHODS: All 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...
2012: Radiation Oncology
Kush Goyal, Douglas Einstein, Rafael A Ibarra, Min Yao, Charles Kunos, Rod Ellis, James Brindle, Deepjot Singh, Jeffrey Hardacre, Yuxia Zhang, Jeffrey Fabians, Gary Funkhouser, Mitchell Machtay, Juan R Sanabria
BACKGROUND: Stereotactic body radiation therapy (SBRT) has emerged as a potential treatment option for local tumor control of primary malignancies of the pancreas. We report on our experience with SBRT in patients with pancreatic adenocarcinoma who were found not to be candidates for surgical resection. METHODS: The prospective database of the first 20 consecutive patients receiving SBRT for unresectable pancreatic adenocarcinomas and a neuroendocrine tumor under an IRB approved protocol was reviewed...
May 15, 2012: Journal of Surgical Research
Marta Scorsetti, Filippo Alongi, Simona Castiglioni, Alessandro Clivio, Antonella Fogliata, Francesca Lobefalo, Pietro Mancosu, Pierina Navarria, Valentina Palumbo, Chiara Pellegrini, Sara Pentimalli, Giacomo Reggiori, Anna M Ascolese, Antonella Roggio, Stefano Arcangeli, Angelo Tozzi, Eugenio Vanetti, Luca Cozzi
PURPOSE: To test feasibility and safety of clinical usage of Flattening Filter Free (FFF) beams for delivering ablative stereotactic body radiation therapy (SBRT) doses to various tumor sites, by means of Varian TrueBeam™ (Varian Medical Systems). METHODS AND MATERIALS: Seventy patients were treated with SBRT and FFF: 51 lesions were in the thorax (48 patients),10 in the liver, 9 in isolated abdominal lymph node, adrenal gland or pancreas. Doses ranged from 32 to 75 Gy, depending on the anatomical site and the volume of the lesion to irradiate...
2011: Radiation Oncology
Brandon M Barney, Kenneth R Olivier, O Kenneth Macdonald, Luis E Fong de Los Santos, Robert C Miller, Michael G Haddock
PURPOSE/OBJECTIVES: To present clinical outcomes, early toxicity, and dosimetric constraints for patients undergoing stereotactic body radiation therapy (SBRT) for abdominal or pelvic tumors. MATERIALS AND METHODS: From May 2008 to February 2010, 47 patients with 50 lesions in proximity to hollow viscous organs at risk, including stomach, duodenum, small bowel, and colon, underwent SBRT at Mayo Clinic. Treated sites included liver (21), lymph node (14), adrenal gland (6), intramuscular (4), pancreas (3), and spleen (2)...
December 2012: American Journal of Clinical Oncology
Anand Mahadevan, Rebecca Miksad, Michael Goldstein, Ryan Sullivan, Andrea Bullock, Elizabeth Buchbinder, Douglas Pleskow, Mandeep Sawhney, Tara Kent, Charles Vollmer, Mark Callery
PURPOSE: Stereotactic body radiotherapy (SBRT) has been used successfully to treat patients with locally advanced pancreas cancer. However, many patients develop metastatic disease soon after diagnosis and may receive little benefit from such therapy. We therefore retrospectively analyzed a planned strategy of initial chemotherapy with restaging and then treatment for those patients with no evidence of metastatic progression with SBRT. METHODS AND MATERIALS: Forty-seven patients received gemcitabine (1,000 mg/m(2) per week for 3 weeks then 1 week off) until tolerance, at least six cycles, or progression...
November 15, 2011: International Journal of Radiation Oncology, Biology, Physics
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