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Pancreatic sbrt

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https://www.readbyqxmd.com/read/28412751/poly-adp-ribose-polymerase-inhibitor-an-effective-radiosensitizer-in-lung-and-pancreatic-cancers
#1
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...
February 17, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28047814/th-cd-207a-09-stay-on-target-dynamic-patient-specific-templates-of-fiducial-marker-clusters-for-igrt
#14
W Campbell, M Miften, B Jones
PURPOSE: Pancreatic SBRT relies on extremely accurate delivery of ablative radiation doses to the target, and intra-fractional tracking of fiducial markers can facilitate improvements in dose delivery. However, this requires algorithms that are able to find fiducial markers with high speed and accuracy. The purpose of this study was to develop a novel marker tracking algorithm that is robust against many of the common errors seen with traditional template matching techniques. METHODS: Using CBCT projection images, a method was developed to create detailed template images of fiducial marker clusters without prior knowledge of the number of markers, their positions, or their orientations...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047289/tu-ab-bra-11-indications-for-online-adaptive-radiotherapy-based-on-dosimetric-consequences-of-interfractional-pancreas-to-duodenum-motion-in-mri-guided-pancreatic-radiotherapy
#15
K Mittauer, S Rosenberg, M Geurts, M Bassetti, I Chen, L Henke, J Olsen, R Kashani, A Wojcieszynski, P Harari, Z Labby, P Hill, B Paliwal, P Parikh, J Bayouth
PURPOSE: Dose limiting structures, such as the duodenum, render the treatment of pancreatic cancer challenging. In this multi-institutional study, we assess dosimetric differences caused by interfraction pancreas-to-duodenum motion using MR-IGRT to determine the potential impact of adaptive replanning. METHODS: Ten patients from two institutions undergoing MRI-guided radiotherapy with conventional fractionation (n=5) or SBRT (n=5) for pancreatic cancer were included...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047015/su-f-t-652-verification-of-inter-fractional-tumor-motion-using-daily-fiducial-length-measurement-for-pancreatic-sbrt
#16
S Jang, M Hwang, D Michalski, R Lalonde, M Huq
PURPOSE: To evaluate possible inter-fractional tumor motion variability for pancreatic SBRT with length measurement of the fiducial depiction on the scan and to develop an empirical correlation using a moving phantom and fiducials for adjusting gating window on a daily basis METHODS: In this retrospective study, motion data for fifty pancreatic SBRT patients with fiducials were selected to find the tumor motion statistics. Three gold fiducials of 5mm were placed around a solid target inside the Quasar Phantom and the 4D CT images of the Phantom were acquired with tumor motion of 1cm in superior-inferior direction...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046885/su-f-j-137-intrafractional-change-of-the-relationship-between-internal-fiducials-and-external-breathing-signal-in-pancreatic-cancer-stereotactic-body-radiation-therapy
#17
N Pettersson, J Murphy, D Simpson, L Cervino
PURPOSE: The use of respiratory gating for management of breathing motion during stereotactic body radiation therapy (SBRT) relies on a consistent relationship between the breathing signal and the actual position of the internal target. This relationship was investigated in patients treated for pancreatic cancer. METHODS: Four patients with pancreatic cancer undergoing SBRT that had implanted fiducials in the tumor were included in this study. Treatment plans were generated based on the exhale phases (30-70%) from the pre-treatment 4DCT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046491/su-c-brb-02-automatic-planning-as-a-potential-strategy-for-dose-escalation-for-pancreas-sbrt
#18
S Wang, D Zheng, R Ma, C Lin, X Zhu, Y Lei, C Enke, S Zhou
PURPOSE: Stereotactic body radiation therapy (SBRT) has been suggested to provide high rates of local control for locally advanced pancreatic cancer. However, the close proximity of highly radiosensitive normal tissues usually causes the labor-intensive planning process, and may impede further escalation of the prescription dose. The present study evaluates the potential of an automatic planning system as a dose escalation strategy. METHODS: Ten pancreatic cancer patients treated with SBRT were studied retrospectively...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28044263/five-fraction-stereotactic-body-radiation-therapy-sbrt-and-chemotherapy-for-the-local-management-of-metastatic-pancreatic-cancer
#19
Jonathan W Lischalk, Aidan Burke, Jessica Chew, Christen Elledge, Marie Gurka, John Marshall, Michael Pishvaian, Sean Collins, Keith Unger
BACKGROUND: The majority of patients with pancreatic cancer are diagnosed with metastatic disease at presentation. Nevertheless, local progression is responsible for up to 30% of deaths and can lead to significant morbidity. As a consequence, further exploration of effective methods of local control and palliation is essential. Stereotactic body radiation therapy (SBRT) is a widely utilized technique for the treatment of localized pancreatic cancer. Here, we report our experience with SBRT and chemotherapy for the local treatment of the metastatic patient population...
January 3, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/27885876/predictors-and-survival-for-pathologic-tumor-response-grade-in-borderline-resectable-and-locally-advanced-pancreatic-cancer-treated-with-induction-chemotherapy-and-neoadjuvant-stereotactic-body-radiotherapy
#20
Eric A Mellon, William H Jin, Jessica M Frakes, Barbara A Centeno, Tobin J Strom, Gregory M Springett, Mokenge P Malafa, Ravi Shridhar, Pamela J Hodul, Sarah E Hoffe
BACKGROUND: Neoadjuvant therapy response correlates with survival in multiple gastrointestinal malignancies. To potentially augment neoadjuvant response for pancreas adenocarcinoma, we intensified treatment with stereotactic body radiotherapy (SBRT) following multi-agent chemotherapy. Using this regimen, we analyzed whether the College of American Pathology (CAP) tumor regression grade (TRG) at pancreatectomy correlated with established response biomarkers and survival. MATERIALS AND METHODS: We identified borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer patients treated according to our institutional clinical pathway who underwent surgical resection with reported TRG (n = 81, median follow-up after surgery 24...
March 2017: Acta Oncologica
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