Abstract
Cancer of the pancreas is the fourth leading cause of death in the United States. Patients with pancreatic cancer have a poor prognosis. The majority of patients are unresectable at the time of diagnosis. The use of stereotactic body radiotherapy (SBRT) for pancreas cancer is promising with the clinical experience showing excellent local control. Major advantages of SBRT include intensified treatment and short treatment time allowing for continued intensive systemic chemotherapy.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bussels B, Goethals L et al (2003) Respiration-induced movement of the upper abdominal organs: a pitfall for the three-dimensional conformal radiation treatment of pancreatic cancer. Radiother Oncol 68(1):69–74
Chang DT, Schellenberg D et al (2009) Stereotactic radiotherapy for unresectable adenocarcinoma of the pancreas. Cancer 115(3):665–672
Chauffert B, Mornex F et al (2008) Phase III trial comparing intensive induction chemoradiotherapy (60 Gy, infusional 5-FU and intermittent cisplatin) followed by maintenance gemcitabine with gemcitabine alone for locally advanced unresectable pancreatic cancer. Definitive results of the 2000-01 FFCD/SFRO study. Ann Oncol 19(9):1592–1599
Conroy T, Desseigne F et al (2011) FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 364(19):1817–1825
Didolkar MS, Coleman CW et al (2010) Image-guided stereotactic radiosurgery for locally advanced pancreatic adenocarcinoma results of first 85 patients. J Gastrointest Surg 14(10):1547–1559
Feng M, Balter JM et al (2009) Characterization of pancreatic tumor motion using cine MRI: surrogates for tumor position should be used with caution. Int J Radiat Oncol Biol Phys 74(3):884–891
Gierga DP, Chen GT et al (2004) Quantification of respiration-induced abdominal tumor motion and its impact on IMRT dose distributions. Int J Radiat Oncol Biol Phys 58(5):1584–1595
Hoyer M, Roed H et al (2005) Phase-II study on stereotactic radiotherapy of locally advanced pancreatic carcinoma. Radiother Oncol 76(1):48–53
Huguet F, Andre T et al (2007) Impact of chemoradiotherapy after disease control with chemotherapy in locally advanced pancreatic adenocarcinoma in GERCOR phase II and III studies. J Clin Oncol 25(3):326–331
Iacobuzio-Donahue CA, Fu B et al (2009) DPC4 gene status of the primary carcinoma correlates with patterns of failure in patients with pancreatic cancer. J Clin Oncol 27(11):1806–1813
Klaassen DJ, MacIntyre JM et al (1985) Treatment of locally unresectable cancer of the stomach and pancreas: a randomized comparison of 5-fluorouracil alone with radiation plus concurrent and maintenance 5-fluorouracil—an Eastern cooperative oncology group study. J Clin Oncol 3(3):373–378
Koong AC, Le QT et al (2004) Phase I study of stereotactic radiosurgery in patients with locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys 58(4):1017–1021
Koong AC, Christofferson E et al (2005) Phase II study to assess the efficacy of conventionally fractionated radiotherapy followed by a stereotactic radiosurgery boost in patients with locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys 63(2):320–323
Loehrer PJ Sr, Feng Y et al (2011) Gemcitabine alone versus gemcitabine plus radiotherapy in patients with locally advanced pancreatic cancer: an Eastern cooperative oncology group trial. J Clin Oncol 29(31):4105–4112
Mahadevan A, Jain S et al (2010) Stereotactic body radiotherapy and gemcitabine for locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys 78(3):735–742
Mahadevan A, Miksad R et al (2011) Induction gemcitabine and stereotactic body radiotherapy for locally advanced nonmetastatic pancreas cancer. Int J Radiat Oncol Biol Phys 81(4):e615–e622 [Epub]
Minn AY, Schellenberg D et al (2009) Pancreatic tumor motion on a single planning 4D-CT does not correlate with intrafraction tumor motion during treatment. Am J Clin Oncol 32(4):364–368
Moertel CG, Frytak S et al (1981) Therapy of locally unresectable pancreatic carcinoma: a randomized comparison of high dose (6000 rads) radiation alone, moderate dose radiation (4000 rads + 5-fluorouracil), and high dose radiation + 5-fluorouracil: The Gastrointestinal Tumor Study Group. Cancer 48(8):1705–1710
Moertel C, Frytak S, Hahn R et al (1988) Treatment of locally unresectable carcinoma of the pancreas: comparison of combined-modality therapy (chemotherapy plus radiotherapy) to chemotherapy alone: gastrointestinal tumor study group. J Natl Cancer Inst 80(10):751–755
Murphy JD, Christman-Skieller C et al (2010) A dosimetric model of duodenal toxicity after stereotactic body radiotherapy for pancreatic cancer. Int J Radiat Oncol Biol Phys 78(5):1420–1426
Polistina F, Costantin G et al (2010) Unresectable locally advanced pancreatic cancer: a multimodal treatment using neoadjuvant chemoradiotherapy (gemcitabine plus stereotactic radiosurgery) and subsequent surgical exploration. Ann Surg Oncol 17(8):2092–2101
Rwigema JC, Parikh SD et al (2011) Stereotactic body radiotherapy in the treatment of advanced adenocarcinoma of the pancreas. Am J Clin Oncol 34(1):63–69
Schellenberg D, Goodman KA et al (2008) Gemcitabine chemotherapy and single-fraction stereotactic body radiotherapy for locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys 72(3):678–686
Schellenberg D, Kim J et al (2011) Single-fraction stereotactic body radiation therapy and sequential gemcitabine for the treatment of locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys 81(1):181–188
Sener SF, Fremgen A et al (1999) Pancreatic cancer: a report of treatment and survival trends for 100, 313 patients diagnosed from 1985–1995, using the national cancer database. J Am Coll Surg 189(1):1–7
Siegel R, Ward E et al (2011) Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin 61(4):212–236
Verbeke CS (2008) Resection margins and R1 rates in pancreatic cancer—are we there yet? Histopathology 52(7):787–796
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Minn, A.Y., Chang, D.T., Koong, A.C. (2011). Pancreatic Cancer. In: Lo, S., Teh, B., Lu, J., Schefter, T. (eds) Stereotactic Body Radiation Therapy. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_456
Download citation
DOI: https://doi.org/10.1007/174_2011_456
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-25604-2
Online ISBN: 978-3-642-25605-9
eBook Packages: MedicineMedicine (R0)