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

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World Journal of Gastroenterology 2022年第7期28卷 745-754页

作者： Tai Ermongkonchai Richard Khor Vijayaragavan Muralidharan Niall Tebbutt Kelvin Lim Numan Kutaiba Sweet Ping Ng Department of Radiation Oncology Olivia Newton-John Cancer Centre at Austin HealthHeidelberg 3084VictoriaAustralia Department of Surgery Austin HealthHeidelberg 3084VictoriaAustralia Department of Medical Oncology Olivia Newton-John Cancer Centre at Austin HealthHeidelberg 3084VictoriaAustralia Department of Diagnostic Radiology Austin HealthHeidelberg 3084VictoriaAustralia

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.

关键词： Magnetic resonance imaging Pancreatic cancer Radiotherapy Stereotactic adaptive techniques

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