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Pancreatic sbrt

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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
#1
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
#2
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
#3
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
#4
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...
October 23, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28994459/neural-network-dose-models-for-knowledge-based-planning-in-pancreatic-sbrt
#5
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
#6
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
#7
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...
August 14, 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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
COMPARATIVE STUDY
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...
September 15, 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
#20
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
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