Radiotherapy Research Today is a free monthly online journal that collates and summarizes the latest research about Radiotherapy, including details on cancer treatment, side effects.

Is there a role for advanced radiation therapy technologies in the treatment of pancreatic adenocarcinoma?

Meyer JJ, Willett CG, Czito BG

Duke University Medical Center, Department of Radiation Oncology, DUMC Box 3085, Durham, NC 27710, USA. jeffrey.meyer@duke.edu

Pancreatic cancer remains a highly challenging problem in oncology. Oncologists continue to search for therapies that are more effective than those currently available to improve on the existing poor treatment results. Persistence of both systemic and local disease causes high rates of morbidity and mortality for patients. Radiation continues to play a role in the treatment of pancreatic cancer, in both the adjuvant and locally advanced settings. Efforts to improve on the results of radiotherapy have led to the use of new and improved technologies. This review discusses a variety of these technological improvements and their current and potential future roles in the clinic.

Published 14 April 2008 in Future Oncol, 4(2): 241-55.
Full-text of this article is available online (may require subscription).

Articles on Radiotherapy published 8 April 2008:

Current neurosurgical management of brain metastases.   Semin Oncol, 35(2): 100-7.

Brain metastases occur in a third of patients diagnosed with cancer; without any intervention, the prognosis is quite poor with a median survival of 1 month. Because of the constraints of the blood-brain barrier, chemotherapy is not effective and treatment options include surgery, whole brain radiation, or stereotactic radiation. This chapter is devoted to a review of the current management options for treatment of brain metastases. [Abstract] [Full-text]

Fistula formation after postoperative radiation treatment for paranasal sinus cancer.   Am J Clin Oncol, 31(2): 199-204.

Postoperative radiation is frequently used in the treatment paradigm for paranasal sinus tumors. The development of 3-dimensional conformal radiation treatment and intensity modulated radiotherapy (IMRT) has facilitated the delivery of high doses required for local control of these lesions while simultaneously decreasing toxicity. At Memorial Sloan-Kettering Cancer Center, a radiation dose of 70 Gy is routinely prescribed to gross tumor, and 59.4 Gy is prescribed to a clinical target volume at ... [Abstract] [Full-text]

Articles on Radiotherapy published 4 April 2008:

Relationship of biochemical outcome to percentage of positive biopsies in men with clinically localized prostate cancer treated with permanent interstitial brachytherapy.   Urology, 71(4): 723-7.

OBJECTIVES: Recent studies have demonstrated that the percentage of positive prostate needle biopsies (PPBs) is an independent predictor of biochemical failure (BF) after radical prostatectomy and external beam radiotherapy. Few studies have confirmed this phenomenon in patients treated with permanent interstitial brachytherapy. We conducted an analysis to determine the clinical utility of the PPBs in predicting BF after permanent interstitial brachytherapy for patients with clinically ... [Abstract] [Full-text]

Articles on Radiotherapy published 1 April 2008:

Optimisation of bronchial brachytherapy catheter placement with a modified airway stent.   Eur Respir J, 31(4): 902-3.

Brachytherapy is a modality of treatment available for lung cancer with tracheal involvement. Correct positioning of the brachytherapy catheter is vital to the optimisation of treatment effect and reduction of complications. Normal airway anatomy and tumour location can make this positioning difficult. The current study presents the case of a 65-yr-old male with invasive tracheal squamous cell carcinoma of the anterior main carina involving the proximal left and right bronchus. The patient was ... [Abstract] [Full-text]

Articles on Radiotherapy published 31 March 2008:

Potential prognostic benefits of radiotherapy as an initial treatment for patients with unresectable advanced hepatocellular carcinoma with invasion to intrahepatic large vessels.   Oncology, 73(1): 90-7.

OBJECTIVES: To examine the efficacy and prognostic benefits of radiotherapy (RT) in patients who have unresectable advanced hepatocellular carcinoma (HCC) with invasion to intrahepatic large vessels (IHLVs). METHODS: Sixty-eight patients who had advanced HCC with invasion to IHLVs were studied. Thirty-two consecutive patients initially received 3-dimensional conformal RT for HCC invasion to IHLVs. Tumor response, prognostic factors, and survival were studied in the patients given RT. Prognostic ... [Abstract] [Full-text]

Evidence behind use of intensity-modulated radiotherapy: a systematic review of comparative clinical studies.   Lancet Oncol, 9(4): 367-75.

Since its introduction more than a decade ago, intensity-modulated radiotherapy (IMRT) has spread to most radiotherapy departments worldwide for a wide range of indications. The technique has been rapidly implemented, despite an incomplete understanding of its advantages and weaknesses, the challenges of IMRT planning, delivery, and quality assurance, and the substantially increased cost compared with non-IMRT. Many publications discuss the theoretical advantages of IMRT dose distributions. ... [Abstract] [Full-text]

The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial.   Lancet Oncol, 9(4): 331-41.

BACKGROUND: The international standard radiotherapy schedule for breast cancer treatment delivers a high total dose in 25 small daily doses (fractions). However, a lower total dose delivered in fewer, larger fractions (hypofractionation) is hypothesised to be at least as safe and effective as the standard treatment. We tested two dose levels of a 13-fraction schedule against the standard regimen with the aim of measuring the sensitivity of normal and malignant tissues to fraction size. METHODS: ... [Abstract] [Full-text]

The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial.   Lancet, 371(9618): 1098-107.

BACKGROUND: The international standard radiotherapy schedule for early breast cancer delivers 50 Gy in 25 fractions of 2.0 Gy over 5 weeks, but there is a long history of non-standard regimens delivering a lower total dose using fewer, larger fractions (hypofractionation). We aimed to test the benefits of radiotherapy schedules using fraction sizes larger than 2.0 Gy in terms of local-regional tumour control, normal tissue responses, quality of life, and economic consequences in women ... [Abstract] [Full-text]

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