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https://www.readbyqxmd.com/read/29771005/prospective-analysis-of-different-combined-regimens-of-stereotactic-body-radiation-therapy-and-chemotherapy-for-locally-advanced-pancreatic-cancer
#1
Xiaofei Zhu, Dongchen Shi, Fuqi Li, Xiaoping Ju, Yangsen Cao, Yuxin Shen, Fei Cao, Shuiwang Qing, Fang Fang, Zhen Jia, Huojun Zhang
To identify impacts of different combined regimens of stereotactic body radiation therapy (SBRT) and chemotherapy on survival of patients with locally advanced pancreatic cancer (LAPC) and factors correlated with determinations of different combinations. Four hundred and nineteen patients with radiographically and biopsy-proven LAPC were prospectively enrolled. Factors associated with different strategies were analyzed with Chi-square test and contingency coefficients. Cox regression was used to identify factors predictive of survival...
May 17, 2018: Cancer Medicine
https://www.readbyqxmd.com/read/29765792/stereotactic-mri-guided-adaptive-radiation-therapy-smart-for-locally-advanced-pancreatic-cancer-a-promising-approach
#2
Elaine Luterstein, Minsong Cao, James Lamb, Ann C Raldow, Daniel A Low, Michael L Steinberg, Percy Lee
Locally advanced pancreatic cancer (LAPC) is characterized by poor prognosis and low response durability with standard-of-care chemotherapy or chemoradiotherapy treatment. Stereotactic body radiation therapy (SBRT), which has a shorter treatment course than conventionally fractionated radiotherapy and allows for better integration with systemic therapy, may confer a survival benefit but is limited by gastrointestinal toxicity. Stereotactic MRI-guided adaptive radiation therapy (SMART) has recently gained attention for its potential to increase treatment precision and thus minimize this toxicity through continuous real-time soft-tissue imaging during radiotherapy...
March 14, 2018: Curēus
https://www.readbyqxmd.com/read/29696321/linac-based-stereotactic-body-radiation-therapy-for-unresectable-locally-advanced-pancreatic-cancer-risk-adapted-dose-prescription-and-image-guided-delivery
#3
Rosario Mazzola, Sergio Fersino, Dario Aiello, Fabiana Gregucci, Umberto Tebano, Stefanie Corradini, Gioacchino Di Paola, Massimo Cirillo, Luca Tondulli, Giacomo Ruffo, Ruggero Ruggieri, Filippo Alongi
BACKGROUND: Stereotactic body radiation therapy (SBRT) represents a new treatment option for locally advanced pancreatic cancer (LAPC). An accurate treatment planning with risk-adapted dose prescription with adherence to specific dose constraints for organs at risk (OARs) and the use of daily cone beam CT (CBCT) for image guidance could allow an effective and safe treatment delivery. Here, feasibility and efficacy of SBRT in LAPC treated in our cancer care center are reported. PATIENTS AND METHODS: 33 unresectable LAPC patients underwent SBRT...
April 25, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/29662656/stereotactic-body-radiation-therapy-for-palliative-management-of-pancreatic-adenocarcinoma-in-elderly-and-medically-inoperable-patients
#4
John F Ryan, Lauren M Rosati, Vincent P Groot, Dung T Le, Lei Zheng, Daniel A Laheru, Eun J Shin, Juan Jackson, Joseph Moore, Amol K Narang, Joseph M Herman
Stereotactic body radiation therapy (SBRT) represents a promising treatment option for patients with localized pancreatic ductal adenocarcinoma (PDAC) who cannot tolerate surgical therapy. We retrospectively reviewed the records of patients with localized PDAC treated with SBRT at our institution between 2010 and 2016 to identify patients deemed medically inoperable due to poor performance status, advanced age, and/or comorbid conditions. Overall survival (OS), progression-free survival (PFS), and local progression-free survival (LPFS) were estimated using Kaplan-Meier curves...
March 27, 2018: Oncotarget
https://www.readbyqxmd.com/read/29564223/stereotactic-body-radiation-therapy-for-locally-progressive-and-recurrent-pancreatic-cancer-after-prior-radiation
#5
Philip Sutera, Mark E Bernard, Hong Wang, Nathan Bahary, Steven Burton, Herbert Zeh, Dwight E Heron
Introduction: Pancreatic adenocarcinoma is an aggressive malignancy that has consistently demonstrated poor outcomes despite aggressive treatments. Despite multimodal treatment, local disease progression and local recurrence are common. Management of recurrent or progressive pancreatic carcinomas proves a further challenge. In patients previously treated with radiation therapy, stereotactic body radiation therapy (SBRT) is a promising modality capable of delivering high dose to the tumor while limiting dose to critical structures...
2018: Frontiers in Oncology
https://www.readbyqxmd.com/read/29564168/impact-of-sarcopenia-in-borderline-resectable-and-locally-advanced-pancreatic-cancer-patients-receiving-stereotactic-body-radiation-therapy
#6
William H Jin, Eric A Mellon, Jessica M Frakes, Gilbert Z Murimwa, Pamela J Hodul, Jose M Pimiento, Mokenge P Malafa, Sarah E Hoffe
Background: Total psoas area (TPA), a marker of sarcopenia, has been used as an independent predictor of clinical outcomes in gastrointestinal (GI) cancers as a proxy for frailty and nutritional status. Our study aimed to evaluate whether TPA, in contrast to traditional measurements of nutrition like body mass index (BMI) and body surface area (BSA), was predictive of outcomes in borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC) patients receiving stereotactic body radiation therapy (SBRT)...
February 2018: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29455086/combination-of-pre-treatment-dwi-signal-intensity-and-s-1-treatment-a-predictor-of-survival-in-patients-with-locally-advanced-pancreatic-cancer-receiving-stereotactic-body-radiation-therapy-and-sequential-s-1
#7
Yu Zhang, Xiaofei Zhu, Ri Liu, Xianglian Wang, Gaofeng Sun, Jiaqi Song, Jianping Lu, Huojun Zhang
OBJECTIVE: To identify whether the combination of pre-treatment radiological and clinical factors can predict the overall survival (OS) in patients with locally advanced pancreatic cancer (LAPC) treated with stereotactic body radiation and sequential S-1 (a prodrug of 5-FU combined with two modulators) therapy with improved accuracy compared with that of established clinical and radiologic risk models. METHODS: Patients admitted with LAPC underwent diffusion weighted imaging (DWI) scan at 3...
April 2018: Translational Oncology
https://www.readbyqxmd.com/read/29448308/perioperative-outcomes-and-survival-following-neoadjuvant-stereotactic-body-radiation-therapy-sbrt-versus-intensity-modulated-radiation-therapy-imrt-in-pancreatic-adenocarcinoma
#8
Brandon C Chapman, Ana Gleisner, Devin Rigg, Cheryl Meguid, Karyn Goodman, Brian Brauer, Csaba Gajdos, Richard D Schulick, Barish H Edil, Martin D McCarter
BACKGROUND AND OBJECTIVES: To compare outcomes in patients receiving neoadjuvant stereotactic body radiation therapy (SBRT) with those receiving intensity-modulated radiation therapy (IMRT) for pancreatic adenocarcinoma. METHODS: We analyzed patients receiving neoadjuvant SBRT for borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) (2012-2016). Differences in baseline characteristics, perioperative outcomes, progression-free survival (PFS), and overall survival (OS) were compared...
February 15, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29357875/optimization-of-dose-distributions-of-target-volumes-and-organs-at-risk-during-stereotactic-body-radiation-therapy-for-pancreatic-cancer-with-dose-limiting-auto-shells
#9
Yangsen Cao, Xiaofei Zhu, Xiaoping Ju, Yongming Liu, Chunshan Yu, Yongjian Sun, Zhitao Dai, Xueling Guo, Huojun Zhang
BACKGROUND: To identify optimization of dose distributions of target volumes and decrease of radiation doses to normal tissues during stereotactic body radiation therapy (SBRT) for pancreatic cancer with dose-limiting auto-shells. METHODS: With the same prescription dose, dose constraints of normal organs and calculation algorithm, treatment plans of each eligible patient were re-generated with 3 shells, 5 shells and 7 shells, respectively. The prescription isodose line and beam number of each patient in 3-shell, 5-shell and 7-shell plan remained the same...
January 22, 2018: Radiation Oncology
https://www.readbyqxmd.com/read/29351303/automated-inverse-optimization-facilitates-lower-doses-to-normal-tissue-in-pancreatic-stereotactic-body-radiotherapy
#10
Ivaylo B Mihaylov, Eric A Mellon, Raphael Yechieli, Lorraine Portelance
PURPOSE: Inverse planning is trial-and-error iterative process. This work introduces a fully automated inverse optimization approach, where the treatment plan is closely tailored to the unique patient anatomy. The auto-optimization is applied to pancreatic stereotactic body radiotherapy (SBRT). MATERIALS AND METHODS: The automation is based on stepwise reduction of dose-volume histograms (DVHs). Five uniformly spaced points, from 1% to 70% of the organ at risk (OAR) volumes, are used...
2018: PloS One
https://www.readbyqxmd.com/read/29327180/chemotherapy-with-or-without-definitive-radiation-therapy-in-inoperable-pancreatic-cancer
#11
Jim Zhong, Jeffrey Switchenko, Madhusmita Behera, David Kooby, Shishir K Maithel, Mark W McDonald, Jolinta Y Lin, Richard J Cassidy, Bassel El-Rayes, Jerome Landry, Pretesh R Patel
BACKGROUND: The LAP07 randomized trial calls into question the role of radiation therapy (RT) in the modern treatment of locally advanced pancreatic cancer (LAPC). However, advances in chemotherapy and RT limit application of the LAP07 results to current clinical practice. Here we utilize the National Cancer Database (NCDB) to evaluate the effects of RT in patients receiving chemotherapy for LAPC. METHODS: Using the NCDB, patients with American Joint Committee on Cancer (AJCC) clinical stage T2-4, N0-1, M0 adenocarcinoma of the pancreas from 2004 to 2014 were analyzed...
April 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29326012/stereotactic-body-radiotherapy-sbrt-for-patients-with-locally-advanced-pancreatic-cancer-a-single-center-experience
#12
Raphaël Jumeau, Guila Delouya, David Roberge, David Donath, Dominic Béliveau-Nadeau, Marie-Pierre Campeau
INTRODUCTION: Despite advances in treatment, notably in systemic therapy, the prognosis of pancreatic adenocarcinoma (PADC) remains dismal. Stereotactic body radiotherapy (SBRT) is an emerging tool in the complex management of PADC. We review outcomes of SBRT for PADC at our institution. METHODS: We reviewed patients treated with SBRT for either unresectable PADC or locally recurrent PADC after surgery. Treatment was delivered using a robotic radiosurgery system with respiratory tracking...
April 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29301352/stereotactic-body-radiation-therapy-in-the-management-of-upper-gi-malignancies
#13
REVIEW
Leila Tchelebi, Nicholas Zaorsky, Heath Mackley
The role of external beam radiation therapy (EBRT) in the management of upper gastrointestinal malignancies is constantly evolving. As radiation therapy techniques improve and are able to deliver more ablative doses of radiotherapy while sparing healthy tissue, radiation can be applied to a wider range of clinical scenarios. Stereotactic body radiation therapy (SBRT) allows a high dose of radiation to be delivered to a highly conformal treatment volume in a short amount of time. Another potential advantage of SBRT is its ability to increase tumor immunogenicity, while also having less of an immunosuppressive effect on the patient, as compared to conventionally fractionated radiation therapy...
January 3, 2018: Biomedicines
https://www.readbyqxmd.com/read/29246032/a-rare-case-of-esophageal-metastasis-from-pancreatic-ductal-adenocarcinoma-a-case-report-and-literature-review
#14
Lauren M Rosati, Megan N Kummerlowe, Justin Poling, Amy Hacker-Prietz, Amol K Narang, Eun J Shin, Dung T Le, Elliot K Fishman, Ralph H Hruban, Stephen C Yang, Matthew J Weiss, Joseph M Herman
Purpose: We report a very unique case of an esophageal metastasis from a pancreatic ductal adenocarcinoma (PDAC) primary. Methods: After obtaining consent from the patient, all relevant records of the case were obtained and retrospectively reviewed. Results: At presentation, the patient was diagnosed with synchronous pancreatic and esophageal cancer. He received six months of neoadjuvant therapy including FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) and stereotactic body radiation therapy (SBRT) to the pancreatic tumor followed by a combined pancreaticoduodenectomy and Ivor Lewis esophagectomy...
November 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/29189331/ablative-radiotherapy-doses-for-locally-advanced-pancreatic-cancer-lapc
#15
Christopher H Crane, Eileen M O'Reilly
Standard palliative doses of radiation for locally advanced unresectable pancreatic cancer have had minimal to no impact on survival. Randomized trials evaluating these palliative doses have not shown a significant survival benefit with the use of radiation as consolidation after chemotherapy. Results from nonrandomized studies of 3- to 5-fraction low-dose stereotactic radiation (SBRT) have likewise had a minimal impact, but with less toxicity and a shorter treatment time. Doses of SBRT have been reduced to half the level that is necessary (biological equivalent dose, BED of 53 Gy) to achieve tumor ablation in the treatment of other solid tumors (100 Gy BED) to protect the gastrointestinal (GI) tract...
November 2017: Cancer Journal
https://www.readbyqxmd.com/read/29184848/one-vs-three-fraction-pancreatic-stereotactic-body-radiation-therapy-for-pancreatic-carcinoma-single-institution-retrospective-review
#16
Philip Anthony Sutera, Mark E Bernard, Beant S Gill, Kamran K Harper, Kimmen Quan, Nathan Bahary, Steven A Burton, Herbert Zeh, Dwight E Heron
Background/introduction: Early reports of stereotactic body radiation therapy (SBRT) for pancreatic ductal adenocarcinoma (PDAC) used single fraction, but eventually shifted to multifraction regimens. We conducted a single institution review of our patients treated with single- or multifraction SBRT to determine whether any outcome differences existed. Methods and materials: Patients treated with SBRT in any setting for PDAC at our facility were included, from 2004 to 2014...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/29184680/stereotactic-body-radiotherapy-for-locally-advanced-unresectable-pancreatic-cancer-patterns-of-care-and-overall-survival
#17
Michael J Dohopolski, Scott M Glaser, John A Vargo, Goundappa K Balasubramani, Sushil Beriwal
Background: Unresectable pancreatic cancer remains a challenging disease to treat. Stereotactic body radiotherapy (SBRT) allows for a higher biologically equivalent dose in an abbreviated course more convenient for patients and the integration of systemic therapy. We sought to investigate utilization trends and survival outcomes for patients treated with pancreatic SBRT versus conventionally fractionated radiotherapy (CFRT). Methods: We engaged the National Cancer Database (NCDB) from 1998-2012 and identified locally-advanced unresectable patients with histologically confirmed, non-metastatic, pancreatic adenocarcinoma who received radiotherapy...
October 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29157747/multiplex-proximity-ligation-assay-to-identify-potential-prognostic-biomarkers-for-improved-survival-in-locally-advanced-pancreatic-cancer-patients-treated-with-stereotactic-body-radiation-therapy
#18
Avani D Rao, Yufei Liu, Rie von Eyben, Charles C Hsu, Chen Hu, Lauren M Rosati, Arti Parekh, Kendall Ng, Amy Hacker-Prietz, Lei Zheng, Timothy M Pawlik, Daniel A Laheru, Elizabeth M Jaffee, Matthew J Weiss, Dung T Le, Ralph H Hruban, Ana De Jesus-Acosta, Christopher L Wolfgang, Amol K Narang, Daniel T Chang, Albert C Koong, Joseph M Herman
PURPOSE: To explore seromarker levels for associations with outcomes in locally advanced pancreatic cancer (LAPC) patients who received chemotherapy and stereotactic body radiation therapy (SBRT). METHODS AND MATERIALS: Serum from LAPC patients in 2 prospective trials of hypofractionated SBRT (5-6.6 Gy × 5) was collected before SBRT. Proximity ligation assay quantified the expression levels of 36 pancreatic cancer-specific candidate seromarkers: Axl, BMP2, CA 125, CA 19-9, CEA, CXCL-1/6/9/10, EGFR, Gas6, Her2, IGF-2, IGFBP-2/3/7, IL-6/6Ra/7/8/12, mesothelin, MMP-1/2/3/7, osteopontin, PDGFRa, PDK1, PF4, RegIV, SPARC, TGF-β, VEGF-A/D, and YKL40...
February 1, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29153290/locally-advanced-pancreatic-cancer-an-emerging-entity
#19
REVIEW
Grainne M O Kane, Jennifer J Knox
Pancreatic adenocarcinoma (PDAC) remains a highly fatal disease that is increasing in incidence. PDAC can be classified according to resectability status with 3 nonmetastatic groups defined: resectable, borderline resectable, and locally advanced PDAC (LAPC). Delineating these subtypes is important with the optimal treatment approach dictated by high-quality CT imaging and multidisciplinary team discussion. Patients with LAPC are thought unresectable and are therefore rarely cured. In these patients, chemotherapy remains the mainstay of treatment...
January 2018: Current Problems in Cancer
https://www.readbyqxmd.com/read/29121945/potential-dosimetric-benefits-of-adaptive-tumor-tracking-over-the-internal-target-volume-concept-for-stereotactic-body-radiation-therapy-of-pancreatic-cancer
#20
Konstantina Karava, Stefanie Ehrbar, Oliver Riesterer, Johannes Roesch, Stefan Glatz, Stephan Klöck, Matthias Guckenberger, Stephanie Tanadini-Lang
BACKGROUND: Radiotherapy for pancreatic cancer has two major challenges: (I) the tumor is adjacent to several critical organs and, (II) the mobility of both, the tumor and its surrounding organs at risk (OARs). A treatment planning study simulating stereotactic body radiation therapy (SBRT) for pancreatic tumors with both the internal target volume (ITV) concept and the tumor tracking approach was performed. The two respiratory motion-management techniques were compared in terms of doses to the target volume and organs at risk...
November 9, 2017: Radiation Oncology
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