Optimizing neoadjuvant radiotherapy for resectable and borderline resectable pancreatic cancer using protons

作     者：Romaine Charles Nichols Michael Rutenberg 

作者机构：Department of Radiation Oncology University of Florida College of Medicine 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2019年第11卷第7期

页      面：303-307页

核心收录：

学科分类：10[医学] 

主　　题：Radiation oncology Pancreatic cancer Proton therapy 

摘      要：Approximately 25%of patients diagnosed with pancreatic cancer present with non-metastatic resectable or borderline resectable ***,the cure rate for these“curablepatients is only in the range of 20%.Local-regional failure rates may exceed 50%after margin-negative,node-negative pancreatectomy,but up to 80%of resections are associated with regional lymph node or margin *** systemic drug therapy and chemotherapy may prevent or delay the appearance of distant metastases,it is unlikely to have a significant impact on local-regional disease *** radiotherapy would represent a rational intervention to improve local-regional *** barrier to preoperative radiotherapy is the concern that it could potentially complicate what is already a long and complicated *** the radiotherapy is delivered with X-rays(photons),the entire cylinder of the abdomen is irradiated;therefore,an operating surgeon may be reluctant to accept the associated risk of increased *** preoperative radiotherapy is delivered with protons,however,significant bowel and gastric tissue-sparing is achieved and clinical outcomes indicate that proton therapy does not increase the risk of operative complications nor extend the length of the procedure.