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https://www.readbyqxmd.com/read/28740913/reirradiation-with-stereotactic-body-radiation-therapy-after-prior-conventional-fractionation-radiation-for-locally-recurrent-pancreatic-adenocarcinoma
#1
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
#2
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
#3
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...
July 14, 2017: Cancer
https://www.readbyqxmd.com/read/28705005/radiation-therapy-in-the-management-of-pancreatic-adenocarcinoma-review-of-current-evidence-and-future-opportunities
#4
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
#5
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
https://www.readbyqxmd.com/read/28661823/stereotactic-body-radiation-vs-intensity-modulated-radiation-for-unresectable-pancreatic-cancer
#6
Joseph J Park, Carla Hajj, Marsha Reyngold, Weiji Shi, Zhigang Zhang, John J Cuaron, Christopher H Crane, Eileen M O'Reilly, Maeve A Lowery, Kenneth H Yu, Karyn A Goodman, Abraham J Wu
BACKGROUND: Stereotactic body radiation therapy (SBRT) is an emerging treatment option for unresectable pancreatic cancer, and is postulated to be more effective and less toxic than conventionally fractionated intensity modulated radiation therapy (IMRT). MATERIAL AND METHODS: We retrospectively reviewed unresectable stage I-III pancreatic adenocarcinoma treated from 2008 to 2016 at our institution with SBRT (five fractions, 30-33 Gy) or IMRT (25-28 fractions, 45-56 Gy with concurrent chemotherapy)...
June 29, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28637480/institutional-analysis-of-stereotactic-body-radiotherapy-sbrt-for-oligometastatic-lymph-node-metastases
#7
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
#8
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
#9
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...
July 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28571887/an-evaluation-of-motion-mitigation-techniques-for-pancreatic-sbrt
#10
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...
July 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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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