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Management of Pancreatic Cancer with MRI-Guided Adaptive Radiotherapy

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A Practical Guide to MR-Linac

Abstract

Globally, pancreatic ductal adenocarcinoma (PDAC) is the 14th most common cancer type and the seventh most common cause of cancer-related death. This disease is treated as a systemic process even though approximately 30% of patients with PDAC die with locally destructive disease. Locoregional control can be improved by escalating radiation dose with modern treatment techniques such as stereotactic body radiotherapy (SBRT) and now with magnetic resonance imaging (MRI)-guided adaptive radiotherapy (MRgRT). There is mounting evidence showing improved local control with the use of dose-escalated radiation therapy which can translate into better symptom control and therefore quality of life for patients with locally advanced disease. In patients with borderline resectable disease, local high dose radiation therapy can downstage patients allowing resection with negative margins. This chapter details the historical treatment paradigm for PDAC as well as strategies and workflows for treating patients with PDAC using MRgRT.

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Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Dana-Farber Brigham Cancer Center, Harvard Medical School, Boston, MA, USA

    Ritchell van Dams

  2. Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada

    Sylvia S. W. Ng

  3. Department of Radiation Oncology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    John Hayes & Tarita O. Thomas

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  1. Ritchell van Dams
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  2. Sylvia S. W. Ng
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  3. John Hayes
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  4. Tarita O. Thomas
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Corresponding author

Correspondence to Ritchell van Dams .

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Indra J. Das

  2. Department of Advanced Radiation Oncology, Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy

    Filippo Alongi

  3. Department of Radiation Oncology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Poonam Yadav

  4. Department of Radiation Oncology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Bharat B. Mittal

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van Dams, R., Ng, S.S.W., Hayes, J., Thomas, T.O. (2024). Management of Pancreatic Cancer with MRI-Guided Adaptive Radiotherapy. In: Das, I.J., Alongi, F., Yadav, P., Mittal, B.B. (eds) A Practical Guide to MR-Linac. Springer, Cham. https://doi.org/10.1007/978-3-031-48165-9_13

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  • DOI: https://doi.org/10.1007/978-3-031-48165-9_13

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