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https://www.readbyqxmd.com/read/28637480/institutional-analysis-of-stereotactic-body-radiotherapy-sbrt-for-oligometastatic-lymph-node-metastases
#1
Rosanna Yeung, Jeremy Hamm, Mitchell Liu, Devin Schellenberg
BACKGROUND: In limited metastatic burden of disease, stereotactic body radiotherapy (SBRT) has been shown to achieve high local control rates. It has been hypothesized that SBRT may translate to a better quality of life by delaying the need for systemic chemotherapy and possibly increasing survival. There is limited published literature on the efficacy of SBRT in limited nodal metastases. The primary aim is to review institutional outcomes of patients with solitary or oligometastatic lymph nodes treated with SBRT...
June 21, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28577833/integration-of-stereotactic-body-radiation-therapy-into-the-multidisciplinary-management-of-pancreatic-cancer
#2
REVIEW
Lauren M Rosati, Rachit Kumar, Joseph M Herman
Although most patients with pancreatic cancer die of metastatic disease, an autopsy study showed that up to one-third of patients die of predominantly local disease. This patient population stands to benefit the most from radiation, surgery, or both. Unfortunately, however, single-agent chemotherapy has had minimal benefit in pancreatic cancer, and most patients progress distantly before receiving radiation therapy (RT). With the addition of multiagent chemotherapy, patients are living longer, and RT has emerged as an important modality in preventing local progression...
July 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28574192/feasibility-study-of-ultrasound-imaging-for-stereotactic-body-radiation-therapy-with-active-breathing-coordinator-in-pancreatic-cancer
#3
Lin Su, Iulian Iordachita, Yin Zhang, Junghoon Lee, Sook Kien Ng, Juan Jackson, Ted Hooker, John Wong, Joseph M Herman, H Tutkun Sen, Peter Kazanzides, Muyinatu A Lediju Bell, Chen Yang, Kai Ding
PURPOSE: Stereotactic body radiation therapy (SBRT) allows for high radiation doses to be delivered to the pancreatic tumors with limited toxicity. Nevertheless, the respiratory motion of the pancreas introduces major uncertainty during SBRT. Ultrasound imaging is a non-ionizing, non-invasive, and real-time technique for intrafraction monitoring. A configuration is not available to place the ultrasound probe during pancreas SBRT for monitoring. METHODS AND MATERIALS: An arm-bridge system was designed and built...
June 2, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28571887/an-evaluation-of-motion-mitigation-techniques-for-pancreatic-sbrt
#4
Warren G Campbell, Bernard L Jones, Tracey Schefter, Karyn A Goodman, Moyed Miften
BACKGROUND AND PURPOSE: Ablative radiation therapy can be beneficial for pancreatic cancer, and motion mitigation helps to reduce dose to nearby organs-at-risk. Here, we compared two competing methods of motion mitigation-abdominal compression and respiratory gating. MATERIALS AND METHODS: CBCT scans of 19 pancreatic cancer patients receiving stereotactic body radiation therapy were acquired with and without abdominal compression, and 3D target motion was reconstructed from CBCT projection images...
May 29, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28493288/outcomes-for-patients-with-locally-advanced-pancreatic-adenocarcinoma-treated-with-stereotactic-body-radiation-therapy-versus-conventionally-fractionated-radiation
#5
Jim Zhong, Kirtesh Patel, Jeffrey Switchenko, Richard J Cassidy, William A Hall, Theresa Gillespie, Pretesh R Patel, David Kooby, Jerome Landry
BACKGROUND: As systemic therapy has improved for locally advanced pancreatic cancer (LAPC), efforts to improve local control with optimal radiotherapy may be critical. Although conventionally fractionated radiation therapy (CFRT) has more recently shown a limited role in LAPC, stereotactic body radiation therapy (SBRT) is an emerging approach with promising results. With no studies to date comparing SBRT with CFRT for LAPC, this study used the National Cancer Data Base (NCDB) to evaluate these 2 modalities...
May 10, 2017: Cancer
https://www.readbyqxmd.com/read/28454218/stereotactic-body-radiation-therapy-for-oligoprogression-of-metastatic-disease-from-gastrointestinal-cancers-a-novel-approach-to-extend-chemotherapy-efficacy
#6
Justin Wray, Rana Fawzi Hawamdeh, Nalini Hasija, Roi Dagan, Anamaria R Yeung, Judith L Lightsey, Paul Okunieff, Karen C Daily, Thomas J George, Robert A Zlotecki, Jose Trevino, Long H Dang
Chemotherapy and targeted therapies are effective palliative options for numerous unresectable or metastatic cancers. However, treatment resistance inevitably develops leading to mortality. In a subset of patients, systemic therapy appears to control the majority of tumors leaving 5 or less to progress, a phenomenon described as oligoprogression. Reasoning that the majority of lesions remain responsive to ongoing systemic chemotherapy, we hypothesized that local treatment of the progressing lesions would confer a benefit...
March 2017: Oncology Letters
https://www.readbyqxmd.com/read/28449702/quantification-of-renal-function-following-stereotactic-body-radiotherapy-for-pancreatic-cancer-secondary-dosimetric-analysis-of-a-prospective-clinical-trial
#7
Vivek Verma, Abhijeet R Bhirud, Kyle A Denniston, Nathan R Bennion, Chi Lin
BACKGROUND: This is the first known study examining renal function following stereotactic body radiotherapy (SBRT) for pancreatic head adenocarcinoma. METHODS: Thirty-eight borderline-resectable/unresectable patients, part of an ongoing prospective trial, underwent 3 cycles of gemcitabine/5-fluorouracil followed by SBRT (5 daily fractions of 5/6/7/8 Gy) and concurrent nelfinavir. Thereafter, in resectable cases, surgery was performed within 4-8 weeks. The last available pre-SBRT creatinine was recorded, along with the highest post-SBRT value...
April 27, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28412751/poly-adp-ribose-polymerase-inhibitor-an-effective-radiosensitizer-in-lung-and-pancreatic-cancers
#8
Kedar Hastak, Steven Bhutra, Renate Parry, James M Ford
The development of stereotactic body radiation therapy (SBRT) has revolutionized radiation therapy for lung cancers and is an emerging treatment option for pancreatic cancers. However, there are many questions on how to optimize its use in chemoradiotherapy. The most relevant addition to radiotherapy regimens are inhibitors of DNA repair and DNA damage response pathways. One such class of agents are inhibitors of poly (ADP-ribose) polymerase (PARP). In this study we examined the effects of the PARP inhibitor LT626 in combination with ionizing radiation in lung and pancreatic cancers...
April 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28282277/role-of-stereotactic-body-radiotherapy-in-the-treatment-of-elderly-and-poor-performance-status-patients-with-pancreatic-cancer
#9
Lauren M Rosati, Joseph M Herman
Literature on the management of nonmetastatic pancreatic ductal adenocarcinoma in patients who are elderly or have poor performance status is sparse. The median survival of this unique cohort of patients is < 6 months, and most patients are only offered single-agent gemcitabine or supportive care. Recently, adding nanoparticle albumin-bound paclitaxel to gemcitabine was shown to improve survival of patients with metastatic disease with Eastern Cooperative Group performance status of 2. Although standard chemoradiotherapy provides long-term locoregional control in locally advanced pancreatic cancer, it is difficult for this group of patients to tolerate 6 weeks of therapy...
March 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28274396/assessing-local-progression-after-stereotactic-body-radiation-therapy-for-unresectable-pancreatic-adenocarcinoma-ct-versus-pet
#10
COMPARATIVE STUDY
Diego A S Toesca, Erqi L Pollom, Peter D Poullos, Lesley Flynt, Yi Cui, Andrew Quon, Rie von Eyben, Albert C Koong, Daniel T Chang
PURPOSE: Evaluation of local tumor progression (LP) has typically been defined by contrast-enhanced computed tomography (CT) imaging after stereotactic body radiation therapy (SBRT) for locally advanced pancreatic cancer (PDAC). The purpose of this study is to determine the benefit of adding 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging to CT for LP assessment of PDAC after SBRT. METHODS AND MATERIALS: We retrospectively reviewed pretreatment, follow-up images, and outcomes of all patients treated with definitive SBRT for unresectable PDAC between December 2002 and December 2015 at our institution...
March 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28138949/stereotactic-body-radiotherapy-sbrt-in-recurrent-or-oligometastatic-pancreatic-cancer-a%C3%A2-toxicity-review-of-simultaneous-integrated-protection-sip-versus-conventional-sbrt
#11
E Gkika, S Adebahr, S Kirste, T Schimek-Jasch, R Wiehle, R Claus, U Wittel, U Nestle, D Baltas, A L Grosu, T B Brunner
BACKGROUND: Stereotactic body radiotherapy (SBRT) in pancreatic cancer can be limited by its proximity to organs at risk (OAR). In this analysis, we evaluated the toxicity and efficacy of two different treatment approaches in patients with locally recurrent or oligometastatic pancreatic cancer. MATERIALS AND METHODS: According to the prescription method, patients were divided in two cohorts (C1 and C2). The planning target volume (PTV) was created through a 4 mm expansion of the internal target volume...
January 30, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28131670/clinical-results-of-stereotactic-body-radiotherapy-sbrt-in-the-treatment-of-isolated-local-recurrence-of-pancreatic-cancer-after-r0-surgery-a-retrospective-study
#12
T Comito, L Cozzi, A Zerbi, C Franzese, E Clerici, A Tozzi, C Iftode, P Navarria, G D'Agostino, A Fogliata, P Mancosu, S Tomatis, C Carnaghi, N Personeni, A Santoro, M Scorsetti
OBJECTIVE: To evaluate the efficacy and the feasibility of SBRT for selected patients with isolated local recurrence of pancreatic cancer after radical surgery. METHODS: A retrospective analysis was performed on patients treated with SBRT for isolated local recurrence from resected pancreatic adenocarcinoma, after multidisciplinary board evaluation. Prescription dose was 45 Gy in 6 fractions for all patients. Primary end-point was freedom from local progression (FFLP)...
April 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28089484/dosimetric-parameters-correlate-with-duodenal-histopathologic-damage-after-stereotactic-body-radiotherapy-for-pancreatic-cancer-secondary-analysis-of-a-prospective-clinical-trial
#13
Vivek Verma, Audrey J Lazenby, Dandan Zheng, Abhijeet R Bhirud, Quan P Ly, Chandrakanth Are, Aaron R Sasson, Chi Lin
PURPOSE: Prospectively assess relationships between dosimetric parameters and histopathologic/clinical duodenal toxicities in patients on a phase I trial for pancreatic cancer. METHODS: Forty-six borderline resectable/unresectable patients were enrolled on a prospective trial testing neoadjuvant gemcitabine/5-fluorouracil followed by SBRT (5 daily fractions of 5-8Gy) and concurrent nelfinavir. Post-SBRT surgery was performed in 13 resectable patients, which constituted the patient population herein...
March 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28069017/dose-escalation-of-stereotactic-body-radiotherapy-sbrt-for-locally-advanced-unresectable-pancreatic-cancer-patients-with-cyberknife-protocol-of-a-phase-i-study
#14
Shui-Wang Qing, Xiao-Ping Ju, Yang-Sen Cao, Huo-Jun Zhang
BACKGROUND: Dose escalation of SBRT for locally advanced pancreatic cancer patients had been reported in several studies in one or three fractions, and phase I protocol was developed to investigate the maximum tolerated dose with CyberKnife for locally advanced unresectable pancreatic cancer patients in five fractions. METHODS: The study is designed as a mono-center phase I study. The primary endpoint is to determine the maximum tolerated dose by frequency of III/IV GI (gastrointestinal) toxicity...
January 9, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28068239/stereotactic-body-radiation-therapy-for-locally-advanced-pancreatic-cancer-a-systematic-review-and-pooled-analysis-of-19-trials
#15
REVIEW
Fausto Petrelli, Tiziana Comito, Antonio Ghidini, Valter Torri, Marta Scorsetti, Sandro Barni
PURPOSE: Although surgery is the standard of care for resectable pancreatic cancer (PC), standard-dose chemoradiation therapy and chemotherapy alone are suitable for patients with unresectable disease. Stereotactic body radiation therapy (SBRT) is an alternative, focused local therapy that delivers high radiation doses within a few fractions to the cancer, sparing the surrounding critical tissue. We performed a systematic review and pooled analysis of published trials to evaluate the efficacy and safety of this emerging treatment modality...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28065427/systematic-review-on-the-treatment-of-isolated-local-recurrence-of-pancreatic-cancer-after-surgery-re-resection-chemoradiotherapy-and-sbrt
#16
REVIEW
Vincent P Groot, Hjalmar C van Santvoort, Steffi J E Rombouts, Jeroen Hagendoorn, Inne H M Borel Rinkes, Marco van Vulpen, Joseph M Herman, Christopher L Wolfgang, Marc G Besselink, I Quintus Molenaar
BACKGROUND: The majority of patients who have undergone a pancreatic resection for pancreatic cancer develop disease recurrence within two years. In around 30% of these patients, isolated local recurrence (ILR) is found. The aim of this study was to systematically review treatment options for this subgroup of patients. METHODS: A systematic search was performed in PubMed, Embase and the Cochrane Library. Studies reporting on the treatment of ILR after initial curative-intent resection of primary pancreatic cancer were included...
February 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28048355/th-cd-207a-04-optimized-respiratory-gating-for-abnormal-breathers-in-pancreatic-sbrt
#17
W Campbell, M Miften, T Schefter, K Goodman, B Jones
PURPOSE: Pancreatic SBRT is uniquely challenging due to both the erratic/unstable motion of the pancreas and the close proximity of the radiosensitive small bowel. Respiratory gating can mitigate this effect, but the irregularity of motion severely affects traditional phase-based gating. The purpose of this study was to analyze real-time motion data of pancreatic tumors to optimize the efficacy and accuracy of respiratory gating, with the overall goal of enabling dose escalated pancreatic SBRT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048258/su-f-r-47-quantitative-shape-relationship-analysis-of-ptv-modification-for-critical-anatomy-sparing-and-its-impact-on-pathologic-response-for-neoadjuvant-stereotactic-radiotherapy-for-pancreatic-cancer
#18
Z Cheng, L Rosati, L Chen, S Robertson, J Moore, L Peng, O Mian, A Narang, A Hacker-Prietz, J Herman, T McNutt
PURPOSE: Stereotactic body radiation therapy (SBRT) may be used to increase surgery candidacy in borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer. However, the planning target volume (PTV) may need to be limited to avoid toxicity when the gross tumor volume (GTV) is anatomically involved with surrounding critical structures. Our study aims to characterize the coverage of GTV and investigate the association between modified PTV and pathologic (pCR) or near pathologic (npCR) complete response rates determined from the surgical specimen...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047832/su-d-bra-06-duodenal-interfraction-motion-with-abdominal-compression
#19
A Witztum, D Holyoake, S Warren, M Partridge, M Hawkins
PURPOSE: To quantify the effect of abdominal compression on duodenal motion during pancreatic radiotherapy. METHODS: Seven patients treated for pancreatic cancer were selected for analysis. Four patients were treated with abdominal compression and three without. The duodenum was contoured by the same physician on each CBCT (five CBCTs for patients with compression, four for non-compression patients). CBCTs were rigidly registered using a soft tissue match and contours were copied to the delivered plans which were all radical (BED > 50 Gy)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047828/su-f-t-563-delivered-dose-reconstruction-of-moving-targets-for-gated-volumetric-modulated-arc-therapy-vmat
#20
H Chung, C Jeong, S Cho, B Cho
PURPOSE: Actual delivered dose of moving tumors treated with gated volumetric arc therapy (VMAT) may significantly differ from the planned dose assuming static target. In this study, we developed a method which reconstructs actual delivered dose distribution of moving target by taking into account both tumor motion and dynamic beam delivery of gated VMAT, and applied to abdominal tumors. METHODS: Fifteen dual-arc VMAT plans (Eclipse, Varian Medical Systems) for 5 lung, 5 pancreatic, and 5 liver cancer patients treated with gated VMAT stereotactic body radiotherapy (SBRT) were studied...
June 2016: Medical Physics
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