title: Stereotactic body radiotherapy for pancreatic cancer: recent progress and future directions.
abstract: Despite advances in surgical, medical, and radiation therapy for pancreatic cancer, the prognosis remains poor. At this time, the only chance for long-term survival is surgical resection. More challenging is the optimal management of unresectable locally advanced pancreatic cancer, which has historically been treated with concurrent chemoradiation or chemotherapy alone. However, the survival and local control benefit of conventional radiotherapy in addition to chemotherapy was unclear. More recently, stereotactic body radiotherapy (SBRT) is emerging as a viable approach to maximizing local tumor control with a tolerable side effect profile. SBRT achieves sharp dose fall-off facilitating safe delivery of highly focused radiation to the tumor over 1-5 days. Although the optimal regimen of pancreas SBRT has not yet been established, its short treatment course limits the delay of additional. Future directions involve prospective study of pancreas SBRT and exploration of biomarkers and imaging technology in order to adopt a personalized management paradigm.
authors.affiliation: a Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre , University of Toronto , Toronto , ON , Canada.
authors.forename: Sten
authors.initials: S
authors.lastname: Myrehaug
authors.affiliation: a Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre , University of Toronto , Toronto , ON , Canada.
authors.forename: Arjun
authors.initials: A
authors.lastname: Sahgal
authors.affiliation: b Department of Radiation Oncology , University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center , Cleveland , OH , USA.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Russo
authors.affiliation: b Department of Radiation Oncology , University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center , Cleveland , OH , USA.
authors.forename: Simon S
authors.initials: SS
authors.lastname: Lo
authors.affiliation: c Department of Radiation Oncology & Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center , Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Rosati
authors.affiliation: d Department of Radiation Oncology , University of Washington , Seattle , WA , USA.
authors.forename: Nina A
authors.initials: NA
authors.lastname: Mayr
authors.affiliation: e Department of Radiation Oncology, London Regional Cancer Program , University of Western Ontario , London , ON , Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Lock
authors.affiliation: f Department of Radiation Oncology , Loyola University Medical Center , Maywood , IL , USA.
authors.forename: William
authors.initials: W
authors.lastname: Small
authors.affiliation: b Department of Radiation Oncology , University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center , Cleveland , OH , USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Dorth
authors.affiliation: b Department of Radiation Oncology , University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center , Cleveland , OH , USA.
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Ellis
authors.affiliation: g Department of Radiation Oncology , Houston Methodist Hospital, Weill Cornell Medical College , Houston , TX , USA.
authors.forename: Bin S
authors.initials: BS
authors.lastname: Teh
authors.affiliation: c Department of Radiation Oncology & Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center , Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Herman
mesh_terms: D006801:Humans; D010190:Pancreatic Neoplasms / Q000532:radiotherapy*; D057285:Precision Medicine / Q000379:methods; D011379:Prognosis; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
keywords: Pancreas cancer; adaptive therapy; radiotherapy; stereotactic