OpenLB
Open Library of Bioscience
Advanced Search
Langenbeck's archives of surgery
Oct, 2015;400 (7): 749-56.

Individualized radiotherapy (iRT) concepts for locally advanced pancreatic cancer (LAPC): indications and prognostic factors.

Stephanie E Combs
Author Information
  1. Stephanie E Combs: Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München (TUM), Ismaninger Straße 22, 81675, Munich, Bavaria, Germany. Stephanie.Combs@tum.de.
PMID: 26139242 DOI: 10.1007/s00423-015-1309-8

Abstract

BACKGROUND: Novel techniques in radiation oncology have significantly improved the therapeutic window in locally advanced pancreatic cancer LAPC. In about one third of the patients, chemoradiation can lead to secondary resectability, contributing to an increase in outcome. Dose-escalation approaches using stereotactic body radiotherapy (SBRT) or advanced treatments such as intensity-modulated radiotherapy (IMRT) can exploit the biological benefits of hypofractionation, or use "dose painting" approaches to target defined subvolumes. Prognostic subgroups of patients have been identified, based on molecular markers such as CA 19-9, nutritional factors, diabetes or immunological properties of tumor and normal tissue.
PURPOSE: The aim of the present manuscript is to summarize data on downsizing for locally advanced pancreatic cancer (LAPC) and to elucidate the role of individualized radiotherapy (iRT).
CONCLUSION: Future concepts focus on iRT based on prognostic factors leading to a true personalized treatment.

Keywords

Locally advanced pancreatic cancer Neoadjuvant chemoradiation Personalized medicine Radiotherapy Stereotactic body radiotherapy (SBRT)

References

J Clin Oncol. 2005 Dec 1;23(34):8863-9 [PMID: 16314646]
Ann Surg Oncol. 2014 Aug;21(8):2801-7 [PMID: 24916745]
Radiother Oncol. 2014 Nov;113(2):290-5 [PMID: 25465732]
Int J Radiat Oncol Biol Phys. 2014 May 1;89(1):175-81 [PMID: 24725700]
Strahlenther Onkol. 2013 Dec;189(12):1051-3 [PMID: 24158636]
J Surg Oncol. 2010 Jun 1;101(7):587-92 [PMID: 20461765]
Int J Radiat Oncol Biol Phys. 2006 Apr 1;64(5):1341-7 [PMID: 16464537]
J Gastrointest Surg. 2008 Jul;12(7):1193-201 [PMID: 18347879]
JAMA. 2007 Jan 17;297(3):267-77 [PMID: 17227978]
Support Care Cancer. 2011 Nov;19(11):1729-34 [PMID: 20967470]
In Vivo. 2014 Nov-Dec;28(6):1135-40 [PMID: 25398812]
Br J Nutr. 2013 Jan 28;109 (2):302-12 [PMID: 23021109]
Ann Surg Oncol. 2015 Jan;22(1):295-301 [PMID: 25037971]
Am J Clin Oncol. 2008 Oct;31(5):446-53 [PMID: 18838880]
Strahlenther Onkol. 2013 Sep;189(9):745-52 [PMID: 23896631]
Clin Cancer Res. 2014 Apr 1;20(7):1865-72 [PMID: 24486587]
Int J Radiat Oncol Biol Phys. 2011 Feb 1;79(2):616-22 [PMID: 20675067]
BMC Cancer. 2006 Sep 07;6:222 [PMID: 16959039]
Clin Cancer Res. 2009 Jul 15;15(14):4674-9 [PMID: 19584151]
N Engl J Med. 2011 May 12;364(19):1817-25 [PMID: 21561347]
Ann Surg Oncol. 1997 Oct-Nov;4(7):551-6 [PMID: 9367020]
Int J Radiat Oncol Biol Phys. 2013 Jul 1;86(3):516-22 [PMID: 23562768]
Radiat Oncol. 2012 Dec 29;7:226 [PMID: 23273161]
JOP. 2012 Sep 10;13(5):497-501 [PMID: 22964956]
Ann Surg Oncol. 2015 Apr;22(4):1168-75 [PMID: 25352267]
Pancreas. 2015 May;44(4):660-4 [PMID: 25760429]
Am J Clin Oncol. 2013 Apr;36(2):151-6 [PMID: 22307213]
Ann Surg Oncol. 2015 Apr;22(4):1153-9 [PMID: 25358667]
Radiother Oncol. 2013 Feb;106(2):186-91 [PMID: 22906549]
Am J Clin Oncol. 2013 Feb;36(1):31-7 [PMID: 22134517]
Chirurg. 2006 Dec;77(12 ):1126-32 [PMID: 17119885]
Strahlenther Onkol. 2015 Jan;191(1):7-16 [PMID: 25252602]
J Natl Cancer Inst. 2010 Mar 3;102(5):340-51 [PMID: 20164446]
Scand J Gastroenterol. 2015;50(9):1170-4 [PMID: 25765175]
Clin Colorectal Cancer. 2014 Dec;13(4):232-8 [PMID: 25442814]
PLoS Med. 2010 Apr 20;7(4):e1000267 [PMID: 20422030]
Oncotarget. 2015 Apr 20;6(11):9592-9 [PMID: 25860937]
Rev Recent Clin Trials. 2015;10(2):142-5 [PMID: 25881637]
Radiother Oncol. 2015 Jan;114(1):117-21 [PMID: 25497876]
Ann Surg Oncol. 2010 Sep;17(9):2321-9 [PMID: 20336387]
Int J Radiat Oncol Biol Phys. 2007 Aug 1;68(5):1557-66 [PMID: 17544599]
Strahlenther Onkol. 2013 Sep;189(9):738-44 [PMID: 23896630]
Med Oncol. 2013 Mar;30(1):361 [PMID: 23271209]
Chirurg. 2010 Jun;81(6):526-32 [PMID: 20508910]
Technol Cancer Res Treat. 2016 Apr;15(2):348-54 [PMID: 25824268]
Int J Radiat Oncol Biol Phys. 2010 Jan 1;76(1):193-200 [PMID: 19604653]
J Clin Oncol. 2008 Jul 20;26(21):3496-502 [PMID: 18640930]
Ann Surg Oncol. 2012 May;19(5):1644-62 [PMID: 22012027]
Oncologist. 2015 Feb;20(2):143-50 [PMID: 25582141]
Cancer Immunol Immunother. 2006 Nov;55(11):1396-405 [PMID: 16485127]
Radiother Oncol. 2012 Apr;103(1):25-31 [PMID: 22300608]
J Gastrointest Oncol. 2013 Dec;4(4):374-9 [PMID: 24294509]
Acta Oncol. 2013 Apr;52(3):498-505 [PMID: 23477361]
BMC Cancer. 2005 Apr 12;5:37 [PMID: 15826316]
Pancreas. 2012 May;41(4):541-6 [PMID: 22504380]
Int J Radiat Oncol Biol Phys. 2011 Sep 1;81(1):181-8 [PMID: 21549517]
Cancer. 2009 Feb 1;115(3):665-72 [PMID: 19117351]
J Gastrointest Oncol. 2013 Jun;4(2):E16-8 [PMID: 23730523]
J Clin Oncol. 2011 Aug 1;29(22):3037-43 [PMID: 21709185]
Pancreatology. 2013 Sep-Oct;13(5):539-43 [PMID: 24075521]
J Clin Oncol. 2008 Jul 20;26(21):3487-95 [PMID: 18640929]
BMC Cancer. 2014 Sep 21;14 :687 [PMID: 25240521]
Oncotarget. 2015 Apr 10;6(10):8255-60 [PMID: 25779664]
Radiother Oncol. 2015 Jan;114(1):109-16 [PMID: 25466369]
Int J Radiat Oncol Biol Phys. 2004 Oct 1;60(2):444-52 [PMID: 15380578]
Radiat Oncol. 2012 Mar 02;7:28 [PMID: 22385572]
J Clin Oncol. 2012 May 1;30(13):1564-5; author reply 1566-7 [PMID: 22412127]
Gan To Kagaku Ryoho. 2009 Nov;36(12):2430-2 [PMID: 20037446]
Ann Oncol. 2014 May;25(5):1025-32 [PMID: 24562449]
BMC Cancer. 2009 May 26;9:160 [PMID: 19470159]
J Radiat Res. 2013 Jul;54 Suppl 1:i61-8 [PMID: 23824129]
Chirurg. 2011 Nov;82(11):981-8 [PMID: 22008845]
J Clin Oncol. 2011 Dec 1;29(34):4548-54 [PMID: 21969517]
Endocrinology. 2006 Sep;147(9):4160-8 [PMID: 16777975]
World J Gastroenterol. 2014 Jul 14;20(26):8482-90 [PMID: 25024604]
BMC Cancer. 2011 Jun 27;11:275 [PMID: 21708005]
J Natl Cancer Inst. 2014 Jan;106(1):djt347 [PMID: 24301456]
Ann Oncol. 2012 Sep;23(9):2327-35 [PMID: 22377565]
Radiat Oncol. 2013 Jul 09;8:175 [PMID: 23837905]
J Immunother. 2007 Jan;30(1):108-15 [PMID: 17198089]
Case Rep Oncol. 2014 Sep 18;7(3):648-55 [PMID: 25408659]
Cancer. 2013 Jan 15;119(2):277-84 [PMID: 22778019]
Surgery. 2015 Jul;158(1):191-200 [PMID: 25900035]
Int J Radiat Oncol Biol Phys. 2014 Jul 15;89(4):830-8 [PMID: 24867540]
J Gastrointest Oncol. 2015 Apr;6(2):108-14 [PMID: 25830030]
Langenbecks Arch Surg. 2015 May;400(4):477-85 [PMID: 25929828]
J Radiat Res. 2013 Jul;54 Suppl 1:i113-9 [PMID: 23824114]
BMC Cancer. 2012 May 29;12 :199 [PMID: 22642850]
Cancer Biol Ther. 2008 Nov;7(11):1806-15 [PMID: 18787407]

MeSH Term

Disease-Free Survival
Female
Humans
Male
Neoadjuvant Therapy
Neoplasm Invasiveness
Neoplasm Staging
Pancreatic Neoplasms
Patient Selection
Precision Medicine
Prognosis
Radiosurgery
Radiotherapy Dosage
Radiotherapy, Intensity-Modulated
Risk Assessment
Survival Analysis
Treatment Outcome
Comparative Study Journal Article Review

Word Cloud

Similar Articles

Cited By