Stereotactic radiotherapy and the potential role of magnetic resonance-guided adaptive techniques for pancreatic cancer

作     者：Tai Ermongkonchai Richard Khor Vijayaragavan Muralidharan Niall Tebbutt Kelvin Lim Numan Kutaiba Sweet Ping Ng 

作者机构：Department of Radiation OncologyOlivia Newton-John Cancer Centre at Austin HealthHeidelberg 3084VictoriaAustralia Department of SurgeryAustin HealthHeidelberg 3084VictoriaAustralia Department of Medical OncologyOlivia Newton-John Cancer Centre at Austin HealthHeidelberg 3084VictoriaAustralia Department of Diagnostic RadiologyAustin HealthHeidelberg 3084VictoriaAustralia 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2022年第28卷第7期

页      面：745-754页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Magnetic resonance imaging Pancreatic cancer Radiotherapy Stereotactic Adaptive techniques 

摘      要：BACKGROUND Pancreatic cancer is a malignancy with one of the poorest prognoses amongst all *** with unresectable tumours either receive palliative care or undergo various chemoradiotherapy *** techniques are often associated with acute gastrointestinal toxicities,as adjacent critical structures such as the duodenum ultimately limits delivered *** body radiotherapy(SBRT)is an advanced radiation technique that delivers highly ablative radiation split into several fractions,with a steep dose fall-off outside target *** To discuss the latest data on SBRT and whether there is a role for magnetic resonance-guided techniques in multimodal management of locally advanced,unresectable pancreatic *** We conducted a search on multiple large databases to collate the latest records on radiotherapy techniques used to treat pancreatic *** of 1229 total records retrieved from our search,36 studies were included in this *** Studies indicate that SBRT is associated with improved clinical efficacy and toxicity profiles compared to conventional radiotherapy *** dose escalation to the tumour with SBRT is limited by the poor soft-tissue visualisation of computed tomography imaging during radiation planning and treatment *** resonance-guided techniques have been introduced to improve imaging quality,enabling treatment plan adaptation and re-optimisation before delivering each *** Therefore,SBRT may lead to improved survival outcomes and safer toxicity profiles compared to conventional techniques,and the addition of magnetic resonance-guided techniques potentially allows dose escalation and conversion of unresectable tumours to operable cases.