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Pancreatic sbrt

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https://www.readbyqxmd.com/read/29327180/chemotherapy-with-or-without-definitive-radiation-therapy-in-inoperable-pancreatic-cancer
#1
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...
January 11, 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
#2
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...
December 21, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29301352/stereotactic-body-radiation-therapy-in-the-management-of-upper-gi-malignancies
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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...
October 12, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29153290/locally-advanced-pancreatic-cancer-an-emerging-entity
#9
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...
November 16, 2017: 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
#10
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
https://www.readbyqxmd.com/read/29063299/stereotactic-body-radiation-therapy-for-isolated-local-recurrence-after-surgical-resection-of-pancreatic-ductal-adenocarcinoma-appears-to-be-safe-and-effective
#11
John F Ryan, Vincent P Groot, Lauren M Rosati, Amy Hacker-Prietz, Amol K Narang, Todd R McNutt, Juan F Jackson, Dung T Le, Elizabeth M Jaffee, Lei Zheng, Daniel A Laheru, Jin He, Timothy M Pawlik, Matthew J Weiss, Christopher L Wolfgang, Joseph M Herman
BACKGROUND: A standardized treatment regimen for unresectable isolated local recurrence (ILR) of pancreatic ductal adenocarcinoma has not been established. This study evaluated the outcomes for patients with ILR who underwent stereotactic body radiation therapy (SBRT). METHODS: The records of patients with ILR who underwent SBRT between 2010 and 2016 were retrospectively reviewed. Symptom palliation and treatment-related toxicity were recorded. Associations between patient or treatment characteristics and overall survival (OS), progression-free survival (PFS), and local progression-free survival (LPFS) were assessed...
January 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28994459/neural-network-dose-models-for-knowledge-based-planning-in-pancreatic-sbrt
#12
Warren G Campbell, Moyed Miften, Lindsey Olsen, Priscilla Stumpf, Tracey Schefter, Karyn A Goodman, Bernard L Jones
PURPOSE: Stereotactic body radiation therapy (SBRT) for pancreatic cancer requires a skillful approach to deliver ablative doses to the tumor while limiting dose to the highly sensitive duodenum, stomach, and small bowel. Here, we develop knowledge-based artificial neural network dose models (ANN-DMs) to predict dose distributions that would be approved by experienced physicians. METHODS: Arc-based SBRT treatment plans for 43 pancreatic cancer patients were planned, delivering 30-33 Gy in five fractions...
October 10, 2017: Medical Physics
https://www.readbyqxmd.com/read/28954285/phase-ii-study-of-proton-based-stereotactic-body-radiation-therapy-for-liver-metastases-importance-of-tumor-genotype
#13
Theodore S Hong, Jennifer Y Wo, Darrell R Borger, Beow Y Yeap, Erin I McDonnell, Henning Willers, Lawrence S Blaszkowsky, Eunice L Kwak, Jill N Allen, Jeffrey W Clark, Shyam Tanguturi, Lipika Goyal, Janet E Murphy, John A Wolfgang, Lorraine C Drapek, Ronald S Arellano, Harvey J Mamon, John T Mullen, Kenneth K Tanabe, Cristina R Ferrone, David P Ryan, A John Iafrate, Thomas F DeLaney, Andrew X Zhu
Background: We evaluated the efficacy and safety of risk-adapted, proton-based stereotactic body radiation therapy (SBRT) for liver metastases from solid tumors. Methods: This single-arm phase II single institutional study (NCT01239381) included patients with limited extrahepatic disease, 800 mL or greater of uninvolved liver, and no cirrhosis or Child-Pugh A, who had received proton-based SBRT to one to four liver metastases from solid tumors. Treatment comprised 30 to 50 Gray equivalent (GyE) in five fractions based on the effective volume of liver irradiated...
September 1, 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28943075/a-novel-absorbable-radiopaque-hydrogel-spacer-to-separate-the-head-of-the-pancreas-and-duodenum-in-radiation-therapy-for-pancreatic-cancer
#14
Avani D Rao, Ziwei Feng, Eun Ji Shin, Jin He, Kevin M Waters, Stephanie Coquia, Robert DeJong, Lauren M Rosati, Lin Su, Dengwang Li, Juan Jackson, Stephen Clark, Jeffrey Schultz, Danielle Hutchings, Seong-Hun Kim, Ralph H Hruban, Theodore L DeWeese, John Wong, Amol Narang, Joseph M Herman, Kai Ding
PURPOSE: We assessed the feasibility and theoretical dosimetric advantages of an injectable hydrogel to increase the space between the head of the pancreas (HOP) and duodenum in a human cadaveric model. METHODS AND MATERIALS: Using 3 human cadaveric specimens, an absorbable radiopaque hydrogel was injected between the HOP and duodenum by way of open laparotomy in 1 case and endoscopic ultrasound (EUS) guidance in 2 cases. The cadavers were subsequently imaged using computed tomography and dissected for histologic confirmation of hydrogel placement...
December 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28890821/feasibility-and-reproducibility-of-substituting-oral-contrast-with-water-for-duodenal-volume-delineation-in-patients-undergoing-pancreatic-stereotactic-body-radiotherapy
#15
Guangyin Wu, Vivek Verma, Matthias F Haefner, Sicong Li, Chi Lin
BACKGROUND: This is the first known report evaluating the feasibility of substituting oral contrast with water in efforts to delineate the duodenum for pancreatic stereotactic body radiotherapy (SBRT). METHODS: From January 2015 to August 2016, 13 patients were simulated after ingestion of 8 ounces of water approximately 15-20 min prior to their simulation scan. We examined the feasibility of contouring the duodenum thereafter, and measured the duodenal volume as well as its variation...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28740913/reirradiation-with-stereotactic-body-radiation-therapy-after-prior-conventional-fractionation-radiation-for-locally-recurrent-pancreatic-adenocarcinoma
#16
Amanda J Koong, Diego A S Toesca, Rie von Eyben, Erqi L Pollom, Daniel T Chang
PURPOSE: Locally recurrent pancreatic cancer after prior radiotherapy is a therapeutic challenge with limited treatment options. This study examines the safety and efficacy of stereotactic body radiation therapy (SBRT) for locally recurrent pancreatic adenocarcinoma after prior conventional fractionation radiotherapy (CRT). METHODS AND MATERIALS: Outcomes from all patients treated with SBRT for locally recurrent pancreatic adenocarcinoma after prior CRT at our institution were reviewed...
January 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/28723668/a-rare-case-of-esophageal-metastasis-from-pancreatic-ductal-adenocarcinoma-a-case-report-and-literature-review
#17
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...
June 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/28708929/stereotactic-body-radiotherapy-for-unresected-pancreatic-cancer-a-nationwide-review
#18
REVIEW
Susanna W L de Geus, Mariam F Eskander, Gyulnara G Kasumova, Sing Chau Ng, Tara S Kent, Joseph D Mancias, Mark P Callery, Anand Mahadevan, Jennifer F Tseng
BACKGROUND: The role of conventional radiotherapy in the management of pancreatic cancer has yet to be elucidated. Over the past decade, stereotactic body radiotherapy (SBRT) has emerged as a novel therapeutic option in pancreatic cancer care. This study evaluated the survival impact of SBRT on patients with unresected pancreatic cancer. METHODS: The National Cancer Data Base was queried for unresected patients who received chemotherapy for nonmetastatic pancreatic adenocarcinoma between 2004 and 2012...
November 1, 2017: Cancer
https://www.readbyqxmd.com/read/28705005/radiation-therapy-in-the-management-of-pancreatic-adenocarcinoma-review-of-current-evidence-and-future-opportunities
#19
Tyler P Robin, Karyn A Goodman
The role of radiation therapy for pancreatic cancer is rapidly evolving in every stage of this disease. In resectable disease, there is conflicting evidence for adjuvant therapy, but an ongoing randomized cooperative group trial is attempting to define the role of adjuvant chemoradiation with modern systemic therapies and radiation techniques with an emphasis on radiation quality assurance. In borderline resectable pancreatic cancer (BRPC), there is an emerging body of literature demonstrating the success of neoadjuvant stereotactic body radiation therapy (SBRT) and a randomized cooperative group trial is actively accruing...
June 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28666905/triphasic-contrast-enhanced-ct-simulation-with-bolus-tracking-for-pancreas-sbrt-target-delineation
#20
Devon J Godfrey, Bhavik N Patel, Justus D Adamson, Ergys Subashi, Joseph K Salama, Manisha Palta
PURPOSE: Bolus-tracked multiphasic contrast computed tomography (CT) is often used in diagnostic radiology to enhance the visibility of pancreas tumors, but is uncommon in radiation therapy pancreas CT simulation, and its impact on gross tumor volume (GTV) delineation is unknown. This study evaluates the lesion conspicuity and consistency of pancreas stereotactic body radiation therapy (SBRT) GTVs contoured in the different contrast phases of triphasic CT simulation scans. METHODS AND MATERIALS: Triphasic, bolus-tracked planning CT simulation scans of 10 consecutive pancreas SBRT patients were acquired, yielding images of the pancreas during the late arterial (LA), portal venous (PV), and either the early arterial or delayed phase...
April 13, 2017: Practical Radiation Oncology
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