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 

机构地区：[1]Department of Radiation Oncology,Olivia Newton-John Cancer Centre at Austin Health,Heidelberg 3084,Victoria,Australia [2]Department of Surgery,Austin Health,Heidelberg 3084,Victoria,Australia [3]Department of Medical Oncology,Olivia Newton-John Cancer Centre at Austin Health,Heidelberg 3084,Victoria,Australia [4]Department of Diagnostic Radiology,Austin Health,Heidelberg 3084,Victoria,Australia

出　　处：《World Journal of Gastroenterology》2022年第7期745-754,共10页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Pancreatic cancer is a malignancy with one of the poorest prognoses amongst all cancers.Patients with unresectable tumours either receive palliative care or undergo various chemoradiotherapy regimens.Conventional techniques are often associated with acute gastrointestinal toxicities,as adjacent critical structures such as the duodenum ultimately limits delivered doses.Stereotactic 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 volumes.AIM 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 cancer.METHODS We conducted a search on multiple large databases to collate the latest records on radiotherapy techniques used to treat pancreatic cancer.Out of 1229 total records retrieved from our search,36 studies were included in this review.RESULTS Studies indicate that SBRT is associated with improved clinical efficacy and toxicity profiles compared to conventional radiotherapy techniques.Further dose escalation to the tumour with SBRT is limited by the poor soft-tissue visualisation of computed tomography imaging during radiation planning and treatment delivery.Magnetic resonance-guided techniques have been introduced to improve imaging quality,enabling treatment plan adaptation and re-optimisation before delivering each fraction.CONCLUSION 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 

分 类 号：R735.9[医药卫生—肿瘤]